幽门螺杆菌耐药菌株的临床相关性：当前数据综述
Clinical relevance of resistant strains of Helicobacter pylori: a review of current data.
作者信息
Mégraud F, Doermann H P
机构信息
Laboratoire de Bactériologie, Hôpital Pellegrin, Bordeaux, France.
出版信息
Gut. 1998 Jul;43 Suppl 1(Suppl 1):S61-5. doi: 10.1136/gut.43.2008.s61.
Abstract
Acquired resistance of Helicobacter pylori to metronidazole and clarithromycin has been reported, with metronidazole resistance being very common. This has an important clinical impact on dual therapies, as well as on the standard triple therapies. However, when antisecretory drug based triple therapies with amoxycillin or clarithromycin and metronidazole are used, the resistance can be overcome in up to 75% of the cases in most of the studies. Clarithromycin seems to be a better choice than amoxycillin to achieve this goal. Nevertheless, resistance to metronidazole remains a risk factor for treatment failure. The most precise information comes from studies in which minimum inhibitory concentrations (MICs) are reported as well as whether the strain is susceptible or resistant. Few data are available from clinical trials to measure the impact of clarithromycin resistance. However, such resistance seems to have a negative impact on the clinical outcome of treatment. It is of greater importance that H pylori resistance is closely monitored in the future.
摘要
已有报道称幽门螺杆菌对甲硝唑和克拉霉素产生了获得性耐药，其中甲硝唑耐药非常常见。这对双重疗法以及标准三联疗法都有重要的临床影响。然而，在大多数研究中，当使用基于抗分泌药物的三联疗法，即阿莫西林或克拉霉素与甲硝唑联合使用时，高达75%的病例中的耐药情况可以得到克服。为实现这一目标，克拉霉素似乎比阿莫西林是更好的选择。尽管如此，对甲硝唑的耐药仍然是治疗失败的一个风险因素。最精确的信息来自那些报告了最低抑菌浓度（MIC）以及菌株是否敏感或耐药的研究。临床试验中几乎没有可用于衡量克拉霉素耐药影响的数据。然而，这种耐药似乎对治疗的临床结果有负面影响。未来密切监测幽门螺杆菌耐药情况更为重要。
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