RESUMO
Helicobacter pylori infection of the stomach is one of the commonest chronic infections world wide and in the Caribbean, over 50 of the population are affected. H pylori is probably transmitted from person to person by oro-fecal and oro-oral means. H pylori is directly associated wirh peptic ulcer disease, chronic antral gastritis, gastric carcinoma and B-cell lymphoma of the stomach. In patients with peptic ulcer and H pylori infection, eradication of infection with antibiotics significantly decreases recurrence of ulcers. All patients with H pylori related disease should be tested and treated if positive. The treatment of H pylori infection has evolved over the years but at present triple therapy which includes two antibiotics is recomended.(AU)
Assuntos
Humanos , Helicobacter pylori , Infecções por Helicobacter/diagnóstico , Infecções por Helicobacter/epidemiologia , Infecções por Helicobacter/tratamento farmacológico , Região do Caribe/epidemiologia , Resultado do Tratamento , Quimioterapia Combinada/administração & dosagem , Quimioterapia Combinada/uso terapêutico , Endoscopia Gastrointestinal , Bombas de Próton/antagonistas & inibidoresRESUMO
OBJECTIVE: Helicobacter pylori eradication is essential in patients with peptic ulcer who are infected with the organism. The rate of eradication is related to the level of antimicrobial resistance to metronidazole, clarithromycin, amoxycillin and tetracycline in H pylori in this community. DESIGN AND METHODS: Gastric biopsies from all patients undergoing upper gastrointestinal endoscopy were cultured. Isolation was done on Thayer-Martin medium under microaerophilic conditions and isolates were sub-cultured on chocolate agar. MICs were determined using the E-test. RESULTS: 64 isolates were available for testing. Metronidazole resistance (MIC > 8mg/l) was observed in 39 percent (25/64), clarithromycin resistance (MIC > 2mg/l) in 4.7 percent (3/64), amoxycillin resistance (MIC > 8mg/l) in 4.7 percent (3/64) and tetracycline resistance (MIC > 4mg/l) in 3.1 percent (2/64). CONCLUSIONS: The high level of metronidazole resistance precludes the use of this antibiotic as first line therapy for H pylori in Barbados. It is recommended that a proton pump inhibitor, amoxycillin and clarithromycin be the combination of choice for eradication of H pylori in patients in Barbados.(Au)
