Antibiotic susceptibility and resistance

Glupczynski, Youri and Megraud, Francis and Hazell, Stuart (2001) Antibiotic susceptibility and resistance. In: Helicobacter pylori: physiology and genetics. American Society for Microbiology, Washington, DC. United States, pp. 511-532. ISBN 1-55581-213-9

Abstract

The realization that peptic ulcer disease was caused by an infectious agent has led to the still ongoing search for the most appropriate therapy. Many therapies have been tried, with the conclusion that multiple drug combinations are at present essential to the achievement of acceptable outcomes; cure of infection in >80% of patients is based on intention to treat. One class of drugs, which has been a constant from the early work of Marshall and Warren, is the 5-nitroimidazoles, principally tinidazole and metronidazole (103), agents that had been used in the treatment of anaerobic bacterial and selected protozoan infections (133). Two other drugs were also used with success in the following years: a macrolide compound, clarithromycin, and a β-lactam compound, amoxicillin. The MACH-1 (94) and MACH-2 (110) studies provided data that the combination of a proton pump inhibitor together with clarithromycin and metronidazole or clarithromycin and amoxicillin represented the most effective drug combinations for the treatment of Helicobacter pylori infection. Yet these combinations are subject to failure due to resistance (4). While the mechanisms of macrolide resistance in H. pylori are well understood, the same cannot be said for resistance to 5-nitroimidazoles. Indeed, the issue of resistance to the 5-nitroimidazoles is confused by apparent problems in relation to the accuracy and reproducibility of susceptibility testing, the definition of resistance, and the perceived clinical relevance of resistance. The issues relating to drug selection and antibiotic resistance as well as the prospect of using genomics for drug discovery will be reviewed in this chapter.


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Item Type: Book Chapter (Commonwealth Reporting Category B)
Refereed: Yes
Item Status: Live Archive
Additional Information: Chaptrer 42 Paper copy held USQ Library 616.01423 Hel
Faculty / Department / School: Historic - Faculty of Sciences - Department of Biological and Physical Sciences
Date Deposited: 30 Nov 2007 11:35
Last Modified: 05 Apr 2018 05:57
Uncontrolled Keywords: antibiotic resistance; peptic ulcers; treatment; infectious agents
Fields of Research : 11 Medical and Health Sciences > 1103 Clinical Sciences > 110307 Gastroenterology and Hepatology
11 Medical and Health Sciences > 1103 Clinical Sciences > 110309 Infectious Diseases
11 Medical and Health Sciences > 1103 Clinical Sciences > 110311 Medical Genetics (excl. Cancer Genetics)
Socio-Economic Objective: C Society > 92 Health > 9201 Clinical Health (Organs, Diseases and Abnormal Conditions) > 920109 Infectious Diseases
URI: http://eprints.usq.edu.au/id/eprint/9592

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