@article{3113243,
    title = "Prospective multicentre study on antibiotic resistance of Helicobacter pylori strains obtained from children living in Europe",
    author = "Koletzko, S. and Richy, F. and Bontems, P. and Crone, J. and Kalach, N. and Monteiro, M.L. and Gottrand, F. and Celinska-Cedro, D. and Roma-Giannikou, E. and Orderda, G. and Kolacek, S. and Urruzuno, P. and Martínez-Gómez, M.J. and Casswall, T. and Ashorn, M. and Bodanszky, H. and Mégraud, F.",
    journal = "Gut Pathogens",
    year = "2006",
    volume = "55",
    number = "12",
    pages = "1711-1716",
    issn = "1757-4749",
    doi = "10.1136/gut.2006.091272",
    keywords = "amoxicillin;  clarithromycin;  metronidazole, antibiotic resistance;  antibiotic sensitivity;  article;  child;  clinical trial;  controlled clinical trial;  controlled study;  Europe;  female;  gastritis;  Helicobacter infection;  Helicobacter pylori;  human;  major clinical study;  male;  multicenter study;  peptic ulcer;  priority journal;  risk factor;  treatment failure, Adolescent;  Age Distribution;  Amoxicillin;  Anti-Infective Agents;  Child;  Child, Preschool;  Clarithromycin;  Drug Resistance, Bacterial;  Drug Resistance, Multiple, Bacterial;  Europe;  Female;  Helicobacter Infections;  Helicobacter pylori;  Humans;  Male;  Metronidazole;  Peptic Ulcer;  Prospective Studies;  Sex Distribution;  Treatment Failure",
    abstract = "Aim: To prospectively assess the antibacterial resistance rate in Helicobacter pylori strains obtained from symptomatic children in Europe. Methods: During a 4-year period, 17 paediatric centres from 14 European countries reported prospectively on patients infected with H pylori, for whom antibiotic susceptibility was tested. Results: A total of 1233 patients were reported from Northern (3%), Western (70%), Eastern (9%) and Southern Europe (18%); 41 % originated from outside Europe as indicated by mother's birth-country; 13% were <6 years of age, 43% 6-11 years of age and 44% >11 years of age. Testing was carried out before the first treatment (group A, n = 1037), and after treatment failure (group B, n = 196). Overall resistance to clarithromycin was detected in 24% (mean, A: 20%, B: 42%). The primary clarithromycin resistance rate was higher in boys (odds ratio (OR) 1.58; 1.12 to 2.24, p = 0.01), in children <6 years compared with >12 years (OR 1.82, 1.10 to 3.03, p = 0.020) and in patients living in Southern Europe compared with those living in Northern Europe (OR 2.25; 1.52 to 3.30, p<0.001). Overall resistance rate to metronidazole was 25% (A: 23%, B: 35%) and higher in children born outside Europe (A: adjusted. OR 2.42, 95% CI: 1.61 to 3.66, p<0.001). Resistance to both antibiotics occurred in 6.9% (A: 5.3%, B: 15.3%). Resistance to amoxicillin was exceptional (0.6%). Children with peptic ulcer disease (80/1180, 6.8%) were older than patients without ulcer (p = 0.001). Conclusion: The primary resistance rate of H pylori strains obtained from unselected children in Europe is high. The use of antibiotics for other indications seems to be the major risk factor for development of primary resistance."
}