A new eradication resistance index as a predictor of metronidazole- containing second-line treatment of Helicobacter pylori

Toshihiro Nishizawa, Hidekazu Suzuki, Tatsuhiro Masaoka, Eisuke Iwasaki, Toshifumi Hibi

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

Background: It is helpful in clinical practice to predict the effects of eradication therapy on Helicobacter pylori. Aim: To develop a useful predictor of the response to metronidazole (MNZ)-containing second-line regimens by combining minimal inhibitory concentrations (MICs) of both amoxicillin (AMX) and MNZ, and the results of urea breath test (UBT) before the treatment. Methods: We enrolled 107 patients who showed eradication failure following first-line triple therapy with a proton pump inhibitor, AMX and clarithromycin. The eradication resistance index was defined as: [pre-treatment UBT result (‰)] × [AMX MIC (μg/ml)] × [MNZ MIC (μg/ml)]. Second-line eradication therapy with lansoprazole, AMX and MNZ was administered for 1 week. Eradication was confirmed by the UBT. Results: The eradication resistance index in subjects showing eradication failure and those showing successful eradication was 9.72 ± 6.63 and 1.25 ± 2.31, respectively (p < 0.001). When a cutoff value of 3 was used, the eradication resistance index predicted the response to therapy with a specificity of 93.8%, sensitivity of 81.8%, and accuracy of 92.5%. Conclusions: The eradication resistance index is a more useful predictor of response to MNZ-containing regimens for second-line treatment than only pretreatment UBT results or MNZ resistance.

Original languageEnglish
Pages (from-to)215-220
Number of pages6
JournalDigestion
Volume76
Issue number3-4
DOIs
Publication statusPublished - 2007

Fingerprint

Metronidazole
Helicobacter pylori
Breath Tests
Amoxicillin
Urea
Therapeutics
Lansoprazole
Clarithromycin
Proton Pump Inhibitors
Sensitivity and Specificity

Keywords

  • C urea breath test
  • Eradication therapy
  • Metronidazole resistance

ASJC Scopus subject areas

  • Gastroenterology

Cite this

A new eradication resistance index as a predictor of metronidazole- containing second-line treatment of Helicobacter pylori. / Nishizawa, Toshihiro; Suzuki, Hidekazu; Masaoka, Tatsuhiro; Iwasaki, Eisuke; Hibi, Toshifumi.

In: Digestion, Vol. 76, No. 3-4, 2007, p. 215-220.

Research output: Contribution to journalArticle

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