The Relationship among Previous Antimicrobial Use and H. Pylori Infections

By Greg Arnold, June 3, 2004, Abstracted from "The Relationship among Previous Antimicrobial Use, Antimicrobial Resistance, and Treatment Outcomes for Helicobacter pylori Infections" in The Annals of Internal
Medicine 2003, Volume 139, pp. 463-469

The use of antibiotics has resulted in an "arms race" between man and Nature. With Nature adapting to antibiotics by mutating and becoming antibiotic-resistant, formation of "superbugs" is now commonplace, so much so that many experts are even discouraging the use of antibacterial soaps for they are ineffective at preventing bacterial infections(2) and may contribute to the "superbug" explosion.

A chronic bacterial infection in people is Helicobacter pylori, the cause of peptic ulcers. It is estimated that one in ten Americans develop a peptic ulcer at some time in his or her life. H. pylori weakens the protective mucous coating of the stomach and duodenum, which allows acid to get through to the sensitive lining beneath, irritating the lining and causing the ulcer. H. pylori is able to survive in stomach acid because it secretes enzymes that neutralize the acid. This mechanism allows H. pylori to make its way to the "safe" area--the protective mucous lining. Once there, the bacterium's spiral shape helps it burrow through the lining.(1)

Now it appears that antibiotic use makes it harder to get rid of peptic ulcers, according to a new study in the Annals of Internal Medicine. Not knowing the relationship between previous antimicrobial treatments and infection with drug-resistant H. Pylori, researchers sought to determine whether previous antibiotic use causes antibiotic
resistance of H. Pylori.

Conducting a retrospective cohort analysis of adults recruited sequentially from a clinical practice, researchers studied 125 adults with an H. Pylori infection in a referral hospital in Anchorage, Alaska. They reviewed antibiotic use in the 10 years before H. Pylori infections occurred and found that 120 of the 125 patients (96%) had
H. Pylori that was resistant to two of the more common antibiotics, clarithromycin and metronidazole.

The researchers concluded, "previous use of macrolides and
metronidazole is associated with H. Pylori resistant to these antimicrobial agents. Clarithromycin resistance is associated with a greater risk for failure with larithromycin-based treatments."

Instead of using antibiotics, a much more viable option for peptic ulcer sufferers is through probiotic supplementation, recently reviewed to be effective as an adjunctive treatment for H. Pylori infection.(3)

References:

1 National Digestive Diseases Information Clearninghouse (NDDIC)
Website: "H. Pylori and Peptic Ulcer"
<http://digestive.niddk.nih.gov/ddiseases/pubs/hpylori/>

2 Larson EL. Effect of antibacterial home cleaning and handwashing
products on infectious disease symptoms: a randomized, double-blind
trial. Annals of Internal Medicine 2004; 140(5): 321-9

3 Hamilton-Miller JM. The role of probiotics in the treatment and
prevention of Helicobacter pylori infection.

Internationals Journal
of Antimicrobial Agents 2003; 22(4): 360-366

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Heather is the Administrator of the IBS Message Boards. She’s the author of Eating for IBS and The First Year: IBS, and the CEO of Heather's Tummy Care. Join her IBS Newsletter. Meet Heather on Facebook!

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