rifampin and Gastritis

The aim of our study was to evaluate and compare the therapeutic efficacy & safety profile of three different antituberculous regimens for pulmonary tuberculosis. The study sample size included 90 newly diagnosed, sputum positive patients of pulmonary. tuberculosis. 30 each from different groups. The parameters studied were, therapeutic efficacy included weight gain, cough, sputum examination and safety profile: nausea, vomiting, anorexia, gastritis, hepatitis, jaundice diarrhoea, rashes, dizziness, tingling & numbness, flu like symptoms & joint aches. Group-I showed statistically significant weight gain when compared to Group-II. Improvement in cough and conversion to smear negative were seen in 100% of patients in Group-I, 83.3% of patients in Group-II and 93.3% of patients in Group-III. Therapeutic efficacy was highest with Group I regimen, followed by Group III and Group II which was least efficacious. Group II also registered; the maximum cost and highest incidence of adverse effects.

Topics: Adult; Antitubercular Agents; Dizziness; Drug Therapy, Combination; Ethambutol; Female; Follow-Up Studies; Gastritis; Humans; Hypesthesia; Isoniazid; Male; Nausea; Pyrazinamide; Rifampin; Streptomycin; Treatment Outcome; Tuberculosis, Pulmonary

To determine the primary and secondary resistance to several antimicrobial agents in Spanish Helicobacter pylori clinical isolates obtained from paediatric patients from January 2002 to June 2006.. Samples were collected from gastric biopsies of symptomatic paediatric patients and H. pylori cultured according to standard microbiological procedures. Resistance was determined by E-test. Strains were considered resistant if minimal inhibitory concentration (MIC) > or = 2 mg/l for amoxycillin, > or = 4 mg/l for tetracycline, > or = 8 mg/l for metronidazole, > or = 1 mg/l for clarithromycin, MIC > or = 4 mg/l for ciprofloxacin, MIC > or = 32 mg/l for rifampicin and intermediate if MIC = 0.5 mg/l for clarithromycin, and MIC = 2 mg/l for ciprofloxacin.. A total of 101 patients were included: 38 males and 63 females (sex ratio M/F: 0.6). Average age was 10 years (range: 4-18 years). All strains were susceptible to amoxycillin, tetracycline and rifampicin, 35.7% were resistant to metronidazole, 54.6% to clarithromycin and 1.8% to ciprofloxacin. 2.0% were intermediate to clarithromycin and 1.8% to ciprofloxacin. Double resistance to metronidazole and clarithromycin rated at 17.2%. Thirty-five patients (34.7%) had a history of treatment failure, and were considered as secondary H. pylori. Primary resistance rates to metronidazole and clarithromycin were 32.8% and 49.2%, respectively, and secondary resistance rates were 41.2% and 70.6%, respectively.. Resistance to clarithromycin (56.6%) was higher than to metronidazole (35.7%) in the H. pylori strains studied. Clarithromycin resistance was very high even in strains from paediatric patients not previously treated for H. pylori infection.

Topics: Adolescent; Amoxicillin; Child; Child, Preschool; Ciprofloxacin; Clarithromycin; Drug Resistance, Microbial; Drug Resistance, Multiple, Bacterial; Female; Gastritis; Helicobacter Infections; Helicobacter pylori; Humans; Male; Metronidazole; Microbial Sensitivity Tests; Rifampin; Spain; Tetracycline

Treatment failure with standard Helicobacter pylori eradication regimes may require the use of 'rescue' therapies containing fluoroquinolones or rifamycins. The susceptibilities of H. pylori in the UK to such antimicrobials are unknown; therefore, this study aimed to determine the frequencies and molecular markers of resistance. Ciprofloxacin and rifampicin susceptibilities were determined by Etest and/or disc diffusion for 255 isolates of H. pylori, including 171 isolates from adult dyspeptic patients with refractive infections. Mutations in known resistance-determining regions of gyrA and rpoB were determined. The ciprofloxacin resistance rate was 7.5 %, and gyrA mutations, predominantly at codon position 91, were identified in most resistant isolates. One isolate (<1 %) had an unequivocal rifampicin-resistant phenotype by Etest yet had no associated mutations in the rpoB gene. As resistance rates were low in H. pylori isolates, including those from patients with refractive infections, it was concluded that fluoroquinolones or rifamycins might be considered in the UK for inclusion in 'rescue' therapies.

Topics: Adult; Ciprofloxacin; DNA Gyrase; Drug Resistance, Bacterial; Gastritis; Genes, Bacterial; Helicobacter Infections; Helicobacter pylori; Humans; Microbial Sensitivity Tests; Molecular Epidemiology; Mutation; Rifampin; United Kingdom

Antibiotic resistance in Helicobacter pylori has been a growing problem with current treatment regimens. However, second-line therapy for cases with eradication failure remains to be established. The aim of this study was to evaluate (in vitro) the potential use of rifampicin for H. pylori eradication. The susceptibility of 52 H. pylori strains isolated from children and adults to amoxicillin, clarithromycin, metronidazole and rifampicin was determined. Forty H. pylori isolates susceptible to these antibiotics were investigated for in vitro inducement of resistance. All isolates were susceptible to rifampicin. None of the H. pylori isolates tested acquired rifampicin resistance during prolonged exposure in in vitro inducement experiments. It is suggested that rifampicin has stable activity against H. pylori.

Topics: Adolescent; Adult; Amoxicillin; Biopsy; Child; Child, Preschool; Clarithromycin; Drug Resistance, Multiple, Bacterial; Drug Therapy, Combination; Duodenal Ulcer; Gastritis; Gastroscopy; Helicobacter Infections; Helicobacter pylori; Humans; Metronidazole; Microbial Sensitivity Tests; Rifampin

Topics: Esophagitis; Female; Gastritis; Humans; Hydrochloric Acid; Middle Aged; Propranolol; Rifampin; Suicide, Attempted