Thai Journal of Gastroenterology

Article :
Helicobacter pylori Eradication Rate in Clarithromycin-resistant trains By Pantoprazole - Amoxicillin - Clarithromycin Regimen

Author :
Phadet Noophun, M.D.
Varocha Mahachai, M.D.
Duangporn Thong-ngam, M.D. Ratha-korn Vilaichone, M.D.,Ph.D.
Somying Tumwasorn, Ph.D. Pinit Kullavanijaya, M.B.chB.

Abstract :

Background: Clarithromycin resistance is an increasing problem in this part of the world and it poten-
tially has an impact on the eradication rate of first line triple therapy (proton pump inhibitor- Amoxicillin-
Clarithromycin) for Helicobacter pylori (H. pylori) infection.
Objective: This study was designed to determine the effect of clarithromycin resistance on the efficacy
of Pantoprazole-Amoxicillin-Clarithromycin for H. pylori eradication in Thai patients with non-ulcer dyspepsia
(NUD).
Patients and Methods: A total of 69 patients with NUD who had undergone upper endoscopy for
dyspeptic symptom and had H. pylori infection as determined by positive urease test and positive culture for
H.pylori were enrolled in this study.  Minimal inhibitory concentrations (MICs) of Clarithromycin were identified
using Epsilometer test (E-test).  The value of MICs cutpoint for Clarithromycin resistant was >1 microgram/ml.
There were 16 patients who had Clarithromycin resistant H. pylori and 53 patients with Clarithromycin sensitive
(C)
H.pylori.  Both groups of patients received Pantoprazole (Controloc
) 40 mg b.i.d., Amoxicillin 500 mg b.i.d. and
(C)
14
) 500 mg 2 tablets daily for 1 week.  H. pylori eradication was evaluated using  C
Clarithromycin (Klacid MR
(C)
urease test (PY-test ) one month after triple therapy was discontinued.
Results: Primary H. pylori resistance to Clarithromycin was observed in 16 of 69 patients (23.2%).  The
eradication rate were 90.6% (48/53) and 56.3% (9/16) in patients with Clarithromycin sensitive and resistant
H.pylori, respectively.  The difference in eradication rate between sensitive and resistant strains was statistically
significant (p = 0.002).
Conclusions: Clarithromycin resistant H. pylori is increasing in this part of the world.  This finding
may have a significant impact on the outcome of H. pylori eradication using regimen containing Clarithromycin.

[Thai J Gastroenterol 2004; 5(2): 93-97]

Keyword :
Helicobacter pylori, eradication, Clarithromycin-resistant

PDF Download :
file/Thai-Journal-of-gastroenterology-vol-5-no-2-1699307.pdf