Susceptibility of Helicobacter pylori to Antibiotics Including Tigecycline

Background: H. pylori antibiotic resistance is an important factor in the treatment failure, therefore is important to know the local pattern of this resistance. Material and Methods: A total of 111 patients were studied. Ninety- one H. pylori strains isolated from patients, including 12 from children, having previous repeated treatment failure and 20 strains were isolated from naive patients, were studied. Antibiotic susceptibility including those to tigecycline, was determinated by E-Test. Results: In treated adult and children patients the resistance rates were respectively 81% and 91.6% for clarithromycin; 27.8% and 41% for amoxicillin; 67.1% and 16.7% for metronidazole; 38% and 8.3% for levofloxacin; 5.1% and 0% for tetracycline. Primary resistance, in naive adult patients was 50% for clarithromycin, 10% for amoxicillin, 20% for metronidazole, 30% for levofloxacin and 0% for tetracycline. Tigecycline has shown good activity, in vitro, against H. pylori (MIC90 = 0.064 mg/L). Conclusion: The resistance rates found in H. pylori, in our area, are very high both in naive and treated patients. Few papers have reported the tigecycline susceptibility in H. pylori. The good activity and the lack of resistance to tigecycline found in our study, may consider this antibiotic a “rescue” therapy, saving the use of other antibiotics such as rifabutin, a drug used for the treatment of tuberculosis.