FINDING THE CHALLENGES OF ERADICATING HELICOBACTER PYLORI AMIDST RISING ANTIBIOTIC RESISTANCE: FUTURE STRATEGIES TO OVERCOME THE HURDLES
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Keywords
H. pylori, antibiotic resistance, eradication, treatment failure
Abstract
ABSTRACT
Background: H. pylori is known to be involved in the etiology of chronic gastritis, peptic ulcer disease and gastric cancer. It has been argued that due to the enhanced antibiotic resistance it has become very difficult to eliminate H. pylori completely through the standard regimes of treatment and it has resulted in higher treatment failure rates.
Objectives: To compare the effect of antibiotic resistance on the rate of H. pylori eradication and other approaches to optimizing the therapy.
Study Design: A Cross Sectional Study
Duration and place of study: Medicine Department, Ayub Teaching Hospital- Abbottabad, from Jan 2022 to Jan 2023.
Methods: One hundred and fifty patients with H. pylori infection confirmed were recruited in the study. All patients received the standard probability of triple therapy including clarithromycin, amoxicillin, and a proton pump inhibitor for 14 days. Antibiotic sensitivities and resistance were established by culture and sensitivity. Parameters measured in the treatment included overall success rate, mean age, standard deviation and p-values.
Results: As to demographics, the average patient age was 45. 6 years (SD = 12. 3). Among 150 patients; 55% were resistant to clarithromycin while 30% to metronidazole. The pooled eradication rate was 65%; however, it was much lower among patients with antibiotic-resistant strains (p = 0. 002). Upon comparing the results on antibiotic resistance with the findings on treatment failure the values were closely related with the p value coming to < 0. 05.
Conclusion: The general efficacy of standard H. pylori treatment regimens has been compromised by the gradual increase in antibiotic resistance. Other approaches such as individualised antibiotic management, as well as the application of new classes of drugs need to be employed in order to address these issues and to enhance levels of clearance.
References
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Saima Bahar
MBBS, FCPS Gastroenterology, Medicine Department, DHQ Hospital, Nowshera
Nimra Tul Ain Khan
Internal Medicine Department, Ayub Teaching Hospital, Abbottabad, Pakistan
Sayyeda Aisha Bahar
MBBS, Ayub Medical College, Resident Physician, Ayub Teaching Hospital, Abbottabad
Raees Ahmed
MBBS Student, Internal Medicine, Ayub Teaching Hospital, Abbottabad.
Kinjal Shah
MBBS, Pramukhswami Medical College, Anand, India Department: Internal Medicine
Kaksha Parrikh
MBBS, Government Medical College, Bhavnagar, Gujarat, India Department: Internal Medicine