AIMS—To compare two strategies forthe eradication of Helicobacter pylori infection. METHODS—Groups 1 and 2 eachconsisted of 75 consecutive patients. Patients in group 1 were treatedwith two antibiotics based on antibiotic susceptibility testing; thosein group 2 received amoxycillin and clarithromycin for eight days,together with either ranitidine or omeprazole. Eradication rate wasassessed in both groups six months after treatment. RESULTS—In group 1, H pylori grew in culture in 63/75 cases.Susceptibility testing showed that 35/63 isolates were resistant tometronidazole, 10/63 to clarithromycin, 2/63 to ampicillin, 1/63 totetracycline, and 5/63 to both clarithromycin and metronidazole. Ingroup 1the infection was eradicated in 96% of the initial 75 subjects, and in 98% of the subjects treated according to theantibiotic assay (62/63). As two patients were lost at follow up theoverall eradication rate was 99%. In group 2, eradication was achieved in 61/75 subjects (81%). This was significantly lower than the percentage of eradication observed in group 1 (81% versus 99%). CONCLUSIONS—Antibioticsusceptibility tests are useful in childhood as a very high percentageof subjects are cured. This approach is costly, but selectiveantibiotic treatment contributes to limit further development ofantibiotic resistance, and money is saved in terms of reinvestigationand further repeated treatments.
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