RESISTANCE OF HELICOBACTER-PYLORI TO METR ONIDAZOLE IN SWITZERLAND - IMPLICATIONS FOR ERADICATION THERAPY

Gastroduodenal ulcers are strongly associated with Helicobacter pylori (HP) infection. Successful eradication drastically diminishes ulcer r ecurrence. Most of the eradication schemes include metronidazole (Flag yl(R)). The present study was designed to establish the metronidazole resistance rate in Switzerland. Antral biopsies were taken in 153 pati ents with suspected ulcers (115 men, 38 women, mean age 46+/-16 [SD] y ears) during upper endoscopy for bacteriological testing. Metronidazol e resistance (>8 mu g/ml) was found in 47/153 (31%) of the isolates. R esistance was found in no case to amoxicillin (Clamoxyl(R)) (0/104 = 0 %) and only in 3% (2/66) to clarithromycin (Klazid(R)). Metronidazole resistance of HP in a third of the isolates studied is comparable to n umbers found in other European countries. These findings raise the que stion whether eradication schemes including metronidazole without prio r sensitivity testing are justified. Amoxicillin and clarythromycin ap pear to be valid alternatives