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Gastroenterology Research and Practice
Volume 2015, Article ID 717349, 5 pages
http://dx.doi.org/10.1155/2015/717349
Research Article

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

1Department of Pediatrics, “Pietro Barilla” Children’s Hospital, Azienda Ospedaliero-Universitaria di Parma, University Hospital, Via Gramsci 14, 43126 Parma, Italy
2Gastroenterology and Endoscopy Unit, Azienda Ospedaliero-Universitaria di Parma, University Hospital, Via Gramsci 14, 43126 Parma, Italy

Received 6 October 2014; Accepted 19 March 2015

Academic Editor: Dimitris S. Ladas

Copyright © 2015 Marco Manfredi et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

The eradication therapy of Helicobacter pylori (H. pylori) infection is still a challenge for gastroenterologists. One of the main causes of failure in H. pylori eradication 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 with H. pylori infection 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 of H. pylori eradication 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%, ). 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 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.