Primary Antimicrobial Susceptibility Changes in Children with Helicobacter pylori Infection over 13 Years in Northern Italy

Abstract EN

The eradication therapy of Helicobacter pylori (H.

pylori) infection is still a challenge forgastroenterologists.

One of the main causes of failure in H.

pylori eradication is the antibioticresistance mainly to clarithromycin.

Culture from biopsies is maybe the most used method amongthe antimicrobial susceptibility techniques.

In this study, we compared the antimicrobialsusceptibility changes in children with H.

pylori infection over 13 years and we confirmed thatclarithromycin resistance has been increased (16% versus 26%) though with no statistically signficantvalue.

Therefore, clarithromycin should not be used in empiric treatment of H.

pylori eradicationtherapy in children, but its use should be limited only to children with known antimicrobialsusceptibility.

On the other hand, metronidazole resistance has decreased over this time period instatistically significant manner (56% versus 33%, p = 0.014 ).

Furthermore, ampicillin resistance has been confirmed to be very rare (3% versus 0%) in children with H.

pylori infection.

In conclusion, in H.

pylori infection, if we do notknow the antibiotic susceptibility of patients, we should recommend an eradication therapy basedon the local distribution of antibiotic resistance rates trying to limit the therapeutic failures.