engleski

Antibiotic resistance patterns of Helicobacter pylori in Croatia: cohort study

Aim. Extensive multi-center studies on Helicobacter pylori infection in several European countries have been recently performed taking into account different regional and medical conditions of population. In this study H. pylori eradication was investigated in Croatia to provide information on regional sensitivity of H. pylori to antibiotic treatment. Methods. The study involved 217 outpatients (107 women and 110 men) in routine clinical practice with the first-line and second-line treatments. The first-line treatment included: omeprazole or pantoprazole triple therapy - omeprazole, amoxicillin, metronidazole (OAM); pantoprazole, amoxicillin, metronidazole (PAM); and ranitidin bismuth citrate, amoxicillin and azithromycin (RBAAz). In the last phase of the second-line treatment, clarithromycin was used. Results. H. pylori was eradicated in 93% of patients, whereas 7% of patients were resistant to all applied therapies. The efficacy of H. pylori eradication in the first-line treatment was 70% for OAM and PAM treatments, and the highest eradication rate of 95% was obtained using the RBAAz treatment, including resistant patients. In the last phase of the second-line treatment, clarithromycin has eradicated 45% of remaining H. pylori strains, which have reacted neither to metronidazole nor to azithromycin alone or in combination with ranitidine bismuth citrate. Conclusion. The optimal therapy for the eradication of H. pylori infection in this study was the RBAAz treatment. On the other hand, metronidazole cannot be recommended because of high H. pylori resistance.

amoxicillin; azthromycin; clarithromycin; drug resistance; microbial resistance; drug therapy; combination therapy; helicobacter pylori; metronidazole; omeprazole; peptic ulcer; ranitidine bismuth citrate

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