Eradication rates of Helicobacter pylori between metronidazole-sensitive and metronidazole-resistant strains with metronidazole containing regimen in Thai patients with peptic ulcer disease.

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dc.contributor.authorWongkusoltham, Pen_US
dc.contributor.authorVilaichone, R Ken_US
dc.contributor.authorKullavanijaya, Pen_US
dc.contributor.authorPhaosawadi, Ken_US
dc.contributor.authorMahachai, Ven_US
dc.date.accessioned2009-05-27T18:20:39Z
dc.date.available2009-05-27T18:20:39Z
dc.date.issued2001-06-01en_US
dc.descriptionChotmaihet Thangphaet.en_US
dc.description.abstractThe results of the in vitro metronidazole resistance on Helicobacter pylori (H. pylori) eradication have been inconclusive. Metronidazole resistance varies among different geographical locations and a previous study from Thailand reported an in vitro metronidazole resistance of H. pylori of 51 per cent. This study was designed to investigate further the effect of the in vitro metronidazole resistance on the outcome of eradication of H. pylori in the Thai population. Fifty two patients with active gastric ulcer (GU) and duodenal ulcer (DU) who had positive culture for H. pylori were studied. All of these patients had positive rapid urease test (CLO test, Delta West, Australia) using gastric biopsy specimens from the antrum and body taken at the time of initial upper endoscopy. In vitro antimicrobial susceptibility test was performed using Epsilometer test (AB Biodisk, Solna, Sweden). All patients received a one-week triple regimen consisting of omeprazole 20 mg twice daily, clarithromycin 500 mg twice daily, metronidazole 500 mg twice daily. Patients with GU continued with another five weeks of omeprazole 20 mg twice daily and patients with DU received another three weeks of omeprazole 20 mg twice daily. Upper endoscopy was repeated at four weeks after the end of the treatment. Three antral and two body biopsy specimens were obtained for identification of H. pylori using CLO test, histology (modified Giemsa stain) and culture. All of these tests had to be negative to confirm a successful eradication. Metronidazole-resistant (MR) strains with MIC > or = 32 mg/l were identified in 27 of the 52 patients (51.92%), whereas, metronidazole-susceptible (MS) strains were isolated from 25 patients (48.08%). Five patients were lost to follow-up and one patient had drug allergy. Successful eradication as defined by negative CLO test, histology and culture was attained in 17/23 (73.91%) patients (GU = 6, DU = 16, GU and DU = 1) with MR strains. 20 out of 23 (86.96%) patients (GU = 9, DU = 12 GU and DU = 2) who had MS strains. The difference was not statistically significant in both groups (P > 0.05). The ulcer healing was, however, highly achieved in both groups (MS = 95.65%, MR = 91.30%, P > 0.05). In vitro metronidazole resistance was high in this population group although this does not predict the outcome of eradication in patients with GU and DU.en_US
dc.description.affiliationDepartment of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.en_US
dc.identifier.citationWongkusoltham P, Vilaichone RK, Kullavanijaya P, Phaosawadi K, Mahachai V. Eradication rates of Helicobacter pylori between metronidazole-sensitive and metronidazole-resistant strains with metronidazole containing regimen in Thai patients with peptic ulcer disease. Journal of the Medical Association of Thailand. 2001 Jun; 84 Suppl 1(): S474-80en_US
dc.identifier.urihttps://imsear.searo.who.int/handle/123456789/38956
dc.language.isoengen_US
dc.source.urihttps://www.mat.or.th/journal/all.phpen_US
dc.subject.meshAdulten_US
dc.subject.meshAgeden_US
dc.subject.meshChi-Square Distributionen_US
dc.subject.meshClarithromycin --administration & dosageen_US
dc.subject.meshDrug Resistanceen_US
dc.subject.meshDrug Therapy, Combinationen_US
dc.subject.meshFemaleen_US
dc.subject.meshFollow-Up Studiesen_US
dc.subject.meshHelicobacter Infections --diagnosisen_US
dc.subject.meshHelicobacter pylori --drug effectsen_US
dc.subject.meshHumansen_US
dc.subject.meshMaleen_US
dc.subject.meshMetronidazole --administration & dosageen_US
dc.subject.meshMicrobial Sensitivity Testsen_US
dc.subject.meshMiddle Ageden_US
dc.subject.meshOmeprazole --administration & dosageen_US
dc.subject.meshProbabilityen_US
dc.subject.meshProspective Studiesen_US
dc.subject.meshStomach Ulcer --drug therapyen_US
dc.subject.meshThailanden_US
dc.subject.meshTreatment Outcomeen_US
dc.titleEradication rates of Helicobacter pylori between metronidazole-sensitive and metronidazole-resistant strains with metronidazole containing regimen in Thai patients with peptic ulcer disease.en_US
dc.typeComparative Studyen_US
dc.typeJournal Articleen_US
dc.typeResearch Support, Non-U.S. Gov'ten_US
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