{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,12]],"date-time":"2026-02-12T08:08:20Z","timestamp":1770883700767,"version":"3.50.1"},"reference-count":41,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2013,6,1]],"date-time":"2013-06-01T00:00:00Z","timestamp":1370044800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. pediatr. gastroenterol. nutr."],"published-print":{"date-parts":[[2013,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objective:<\/jats:title><jats:p>The aim of the present study was to assess the primary and secondary resistance of <jats:italic>Helicobacter pylori<\/jats:italic> strains to clarithromycin, amoxicillin, furazolidone, tetracycline, and metronidazole, the conventional antibiotics presently used in Brazilian children and adolescents.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods:<\/jats:title><jats:p>Seventy\u2010seven consecutive <jats:italic>H pylori<\/jats:italic> strains, 71 of 77 strains obtained from patients without previous eradication treatment for <jats:italic>H pylori<\/jats:italic> infection, and 6 strains from patients in whom previous eradication treatment had failed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results:<\/jats:title><jats:p>Global rate of resistance was 49.3% (38\/77): 40% of strains were resistant to metronidazole, 19.5% to clarithromycin, and 10.4% to amoxicillin. All of the tested <jats:italic>H pylori<\/jats:italic> strains were susceptible to furazolidone and tetracycline. Multiple resistance were detected in 18.2% (14\/77 patients) of the strains: 6 of 14 (43%) simultaneously resistant to clarithromycin and metronidazole; 5 of 14 (36%) to amoxicillin and metronidazole; 2 of 14 (14%) to amoxicillin, clarithromycin, and metronidazole; and 1 of 14 (7%) to clarithromycin and amoxicillin.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions:<\/jats:title><jats:p>The high resistance rate to metronidazole and clarithromycin observed in clinical <jats:italic>H pylori<\/jats:italic> isolates can exclude these antimicrobials in empirical eradication treatment in Brazil. Otherwise, furazolidone and tetracycline presented no resistance. Properly assessing the risks and benefits, these 2 antimicrobials and their derivatives could be used in empirical eradication schedules, both associated with amoxicillin, which showed a low resistance rate despite its wide use in pediatric patients.<\/jats:p><\/jats:sec>","DOI":"10.1097\/mpg.0b013e31828b3669","type":"journal-article","created":{"date-parts":[[2013,2,12]],"date-time":"2013-02-12T12:05:55Z","timestamp":1360670755000},"page":"645-648","source":"Crossref","is-referenced-by-count":41,"title":["High <i>Helicobacter pylori<\/i> Resistance to Metronidazole and Clarithromycin in Brazilian Children and Adolescents"],"prefix":"10.1002","volume":"56","author":[{"given":"Silvio K.","family":"Ogata","sequence":"first","affiliation":[{"name":"Division of Pediatric Gastroenterology, Hepatology, and Nutrition Universidade Federal de S\u00e3o Paulo S\u00e3o Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anita P. 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