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.
Cammarota, G., Branca, G., Ardito, F., Sanguinetti, M., Ianiro, G., Cianci, R., Torelli, R., Masala, G., Gasbarrini, A., Fadda, G., Landolfi, R., Gasbarrini, G. B., Biofilm demolition and antibiotic treatment to eradicate resistant Helicobacter pylori: A clinical trial, <<CLINICAL GASTROENTEROLOGY AND HEPATOLOGY>>, 2010; 8 (9): 817-820. [doi:10.1016/j.cgh.2010.05.006] [https://hdl.handle.net/10807/271883]
Biofilm demolition and antibiotic treatment to eradicate resistant Helicobacter pylori: A clinical trial
Cammarota, GiovanniPrimo
;Sanguinetti, Maurizio;Ianiro, Gianluca;Cianci, Rossella;Gasbarrini, Antonio;Landolfi, Raffaele;Gasbarrini, Giovanni Battista
2010
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.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.