Factors Associated With Treatment Failure of Helicobacter pylori Infection in a Developing Country

BACKGROUNDAlthough no regimen can eradicate Helicobacter pylori in 100% of patients, factors that may affect the eradication rates have been poorly studied. GOALTo evaluate factors associated with H. pylori treatment failure. STUDYOne hundred patients were treated with pantoprazole plus clarithromyc...

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Bibliographic Details
Published in:	Journal of clinical gastroenterology Vol. 35; no. 4; pp. 315 - 320
Main Authors:	Queiroz, Dulciene Maria Magalhães, Dani, Renato, Silva, Luciana Diniz, Santos, Adriana, Moreira, Liano Sia, Rocha, Gifone Aguiar, Corrêa, Paulo Renato Valle, Reis, Luiz Fernando Abrahão, Nogueira, Ana Margarida Ferreira, Álvares Cabral, Mônica Maria Demas, Esteves, Ana Maria Brás, Tanure, Jansen
Format:	Journal Article
Language:	English
Published:	Hagerstown, MD Lippincott Williams & Wilkins, Inc 01-10-2002 Lippincott Williams & Wilkins
Subjects:	2-Pyridinylmethylsulfinylbenzimidazoles Adolescent Adult Aged Anti-Bacterial Agents - administration & dosage Anti-Bacterial Agents - therapeutic use Anti-Infective Agents, Local - administration & dosage Anti-Infective Agents, Local - therapeutic use Anti-Ulcer Agents - administration & dosage Anti-Ulcer Agents - therapeutic use Bacterial diseases Bacterial diseases of the digestive system and abdomen Benzimidazoles - administration & dosage Benzimidazoles - therapeutic use Biological and medical sciences Clarithromycin - administration & dosage Clarithromycin - therapeutic use Developing Countries Drug Resistance, Bacterial Drug Therapy, Combination Female Furazolidone - administration & dosage Furazolidone - therapeutic use Helicobacter Infections - drug therapy Helicobacter pylori - drug effects Human bacterial diseases Humans Infectious diseases Male Medical sciences Middle Aged Omeprazole - analogs & derivatives Pantoprazole Risk Factors Sex Factors Sulfoxides - administration & dosage Sulfoxides - therapeutic use Treatment Failure Tropical medicine South America Brazil America Human Clarithromycin Treatment resistance Spirillales Furan derivatives Sex Spirillaceae Statistical study Macrolide Gastritis Infection Chemotherapy Furazolidone Helicobacter pylori Parasiticid Risk factor Bacteriosis Digestive diseases Bacteria Antibacterial agent Failure Gastric disease
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Summary:	BACKGROUNDAlthough no regimen can eradicate Helicobacter pylori in 100% of patients, factors that may affect the eradication rates have been poorly studied. GOALTo evaluate factors associated with H. pylori treatment failure. STUDYOne hundred patients were treated with pantoprazole plus clarithromycin and furazolidone for H. pylori eradication. Clarithromycin and furazolidone resistance was evaluated by the agar dilution method. Point mutations in 23S rRNA genes related to clarithromycin resistance were investigated by polymerase chain reaction and restriction length fragment polymorphism and cag A by polymerase chain reaction. The data were analyzed by logistic regression. RESULTSH. pylori eradication occurred in 85 of 97 patients who completed the treatment (87.6%; 95% CI = 79.0–93.1). All H. pylori strains were susceptible to furazolidone, and nine were resistant to clarithromycin (A2142G or A2143G mutation was detected in all of them). The treatment failure was significant and independently associated with clarithromycin resistance (OR = 7.79; 95% CI = 1.73–35.01), cag A-negative status (OR = 4.81; 95% CI = 1.14–20.14), and male gender (OR = 4.20; 95% CI = 1.01–17.78), but not with the type of disease, mean age, smoking, alcohol consumption, and the degree of the antral and oxyntic gastritis. CONCLUSIONResistance to clarithromycin, cag A-negative status, and gender were predictive factors of H. pylori eradication failure.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0192-0790 1539-2031
DOI:	10.1097/00004836-200210000-00007