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 (13)C-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. Copyright 2010 AGA Institute. Published by Elsevier Inc. All rights reserved.
RCT Entities:
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 (13)C-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. Copyright 2010 AGA Institute. Published by Elsevier Inc. All rights reserved.
Authors: Stephanie L Servetas; Beth M Carpenter; Kathryn P Haley; Jeremy J Gilbreath; Jennifer A Gaddy; D Scott Merrell Journal: J Bacteriol Date: 2016-08-25 Impact factor: 3.490
Authors: Kai Y Liu; Fang C Du; Qiang Fu; Wei J Zhang; Hong W Sun; Yi Zhang; Le L Gan; Zhi Y Yue; Quan M Zou; Gang Guo Journal: Antimicrob Agents Chemother Date: 2014-03-31 Impact factor: 5.191
Authors: Erik C von Rosenvinge; Graeme A O'May; Sandra Macfarlane; George T Macfarlane; Mark E Shirtliff Journal: Pathog Dis Date: 2013-01-29 Impact factor: 3.166
Authors: Apolinaria García; María José Salas-Jara; Carolina Herrera; Carlos González Journal: World J Gastroenterol Date: 2014-05-21 Impact factor: 5.742