Biofilm demolition and antibiotic treatment to eradicate resistant Helicobacter pylori: A clinical trial

Giovanni Cammarota, Giovanna Branca, Fausta Ardito, Maurizio Sanguinetti, Gianluca Ianiro, Rossella Cianci, Riccardo Torelli, Giovanna Masala, Antonio Gasbarrini, Giovanni Fadda, Raffaele Landolfi, Giovanni Battista Gasbarrini

Risultato della ricerca: Contributo in rivistaArticolo in rivista

Abstract

Background & Aims: Helicobacter pylori attaches to gastric mucosa and grows as a biofilm. This constitutes protection from antimicrobial agents. We assessed the role of a pretreatment with n-acetylcysteine in destroying biofilm and overcoming H pylori antibiotic resistance. Methods: In an open-label, randomized controlled trial, 40 subjects with a history of at least 4 H pylori eradication failures were evaluated for biofilm presence, antibiotic susceptibility, and H pylori genotypes. Subjects were assigned randomly to receive (group A) or not (group B) n-acetylcysteine before a culture-guided antibiotic regimen. The primary end point was the H pylori eradication rate as assessed by 13C-labeled urea breath testing. Results: H pylori was eradicated in 13 of 20 (both per-protocol and intention-to-treat analyses, 65%; 95% confidence interval, 44%-86%) group A participants and 4 of 20 (both per-protocol and intention-to-treat analyses, 20%; 95% confidence interval, 3%-37%) group B participants (P < .01). Biofilms persisted only in unsuccessfully treated participants. H pylori genotypes did not influence treatment outcome. Conclusions: N-acetylcysteine pretreatment before a culture-guided antibiotic regimen is effective in overcoming H pylori antibiotic resistance. © 2010 AGA Institute.
Lingua originaleEnglish
pagine (da-a)817-820
Numero di pagine4
RivistaClinical Gastroenterology and Hepatology
Volume8
DOI
Stato di pubblicazionePubblicato - 2010

Keywords

  • Biofilm
  • Helicobacter pylori
  • Rescue Therapy
  • Resistance

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