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• W2913443377 abstract "Introduction: Study purpose was to review utilization and clinical relevance of H pylori (Hp) PCR data. Data included antibiotic resistance profiles obtained in clinical practice expressly for detection and eradication of Hp. Methods: Retrospective analysis of electronic medical records (EMR) at a community based gastroenterology clinic identified patients evaluated for Hp April 2016 to July 2016. All charts were reviewed for uniformity of data comparison, including Hp eradication by urease breath tests as primary inclusion criteria. Of 105 patients evaluated for Hp status, 39 underwent PCR with antibiogram and received treatment. All tests were obtained during clinical practice. Patients were diagnosed as Hp positive if Hp by PCR, virulence factors by PCR, Campylobacter-like organism test, stool antigen or pathology were noted. PCR antibiotic resistance data included clarithromycin, β-lactamase, nitroimidazole, fluoroquinolone, tetracycline, imidazole and vancomycin. Treatment regimen prescribed was obtained from EMR review. Hp patients who were treated with antibiotic regimens containing at least one drug to which they harbored antibiotic resistance based on PCR results were classified as receiving discordant therapy not in accord with the PCR antibiogram. Results: 21 patients received an antibiotic to which they had PCR-documented resistance, 20 (95.2%) of which demonstrated Hp eradication based on urease breath test. 18 patients received antibiotics all of which were in accord with the antibiogram, 15 of whom showed Hp eradication (83.3%). To the primary endpoint, twenty patients (51.3%) were treated with discordant antibiotic regimens yet still had Hp eradication of 95.2%. Pearson Chi-Square value of 1.49 and Fisher's Exact Test of 0.318 showed no statistically significant association tailoring antibiotic regimens to PCR antibiotic resistance. Strength of association was low with a 95% CI (-0.433, 0.121). Goodman and Kruskal tau was 0.038 with bootstrap analysis of BCa 95% CI (0, 0.283). Conclusion: Hp eradication therapy conflicting with PCR antibiotic resistance profiles did not appear to result in failed treatment as reflected by urease breath testing in the patient population studied. This warrants further study to determine relevance and cost effectiveness of Hp PCR testing in clinical practice." @default.
• W2913443377 created "2019-02-21" @default.
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• W2913443377 date "2017-10-01" @default.
• W2913443377 modified "2023-09-27" @default.
• W2913443377 title "H. pylori in Clinical Practice: When Eradication Therapy Conflicts With PCR Antibiotic Resistance: An Investigation into Clinical Relevance" @default.
• W2913443377 doi "https://doi.org/10.14309/00000434-201710001-01247" @default.
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