Primary Antimicrobial Susceptibility Changes in Children withHelicobacter pyloriInfection over 13 Years in Northern Italy

Abstract

The eradication therapy ofHelicobacter pylori(H. pylori) infection is still a challenge for gastroenterologists. One of the main causes of failure inH. pylorieradication is the antibiotic resistance mainly to clarithromycin. Culture from biopsies is maybe the most used method among the antimicrobial susceptibility techniques. In this study, we compared the antimicrobial susceptibility changes in children withH. pyloriinfection over 13 years and we confirmed that clarithromycin resistance has been increased (16% versus 26%) though with no statistically signficant value. Therefore, clarithromycin should not be used in empiric treatment ofH. pylorieradication therapy in children, but its use should be limited only to children with known antimicrobial susceptibility. On the other hand, metronidazole resistance has decreased over this time period in statistically significant manner (56% versus 33%,p=0.014). Furthermore, ampicillin resistance has been confirmed to be very rare (3% versus 0%) in children withH. pyloriinfection. In conclusion, inH. pyloriinfection, if we do not know the antibiotic susceptibility of patients, we should recommend an eradication therapy based on the local distribution of antibiotic resistance rates trying to limit the therapeutic failures.