{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,30]],"date-time":"2026-03-30T13:21:10Z","timestamp":1774876870618,"version":"3.50.1"},"reference-count":42,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2018,8,9]],"date-time":"2018-08-09T00:00:00Z","timestamp":1533772800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Helicobacter"],"published-print":{"date-parts":[[2018,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The increasing prevalence of<jats:italic>Helicobacter pylori<\/jats:italic>(<jats:italic>H.\u00a0pylori)<\/jats:italic>antimicrobial resistance, primarily for clarithromycin decreases the success of treatment. The aim of this study is to determine the local pattern of first\u2010line antimicrobials resistance and the eradication rate.<\/jats:p><\/jats:sec><jats:sec><jats:title>Material and Methods<\/jats:title><jats:p>Prospective cohort study of<jats:italic>H. pylori<\/jats:italic>infected patients (positive histological or cultural exams) treated at Centro Materno\u2010Infantil do Norte from January of 2013 to October of 2017. Susceptibility to 4 antibiotics: amoxicilin, metronidazole, clarithromycin, and levofloxacin were analyzed by E\u2010test (phenotypic resistance). The E\u2010test was chosen because it is simple and cost\u2010effective for routine susceptibility testing. Point mutations that confer clarithromycin resistance were surveyed (genotypic resistance). Eradication of<jats:italic>H. pylori<\/jats:italic>infection was defined by a negative urea breath test or fecal antigen 6\u20108\u00a0weeks after the end of treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of a total of 74<jats:italic>H. pylori<\/jats:italic>infected patients, 16 were excluded because they had previous<jats:italic>H. pylori<\/jats:italic>treatment or severe systemic disease. Median age of infection cases was 15\u00a0years (3\u201017\u00a0years). Eradication regimen used in all patients combined the use of 3 antibiotics (amoxicillin and metronidazole or clarithromycin) and proton pump inibhitor for 14\u00a0days and was tailored according antimicrobial susceptibility. 79.5% of the patients completed the treatment. The resistance rate for metronidazole and clarithromycin was 3.3% and 23.3%, respectively. There was no resistance for amoxicilin and levofloxacin. The rate of genotypic resistance to clarithromycin was 37.2%. The eradication rate was 97.8%.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The authors found a high resistance rate of<jats:italic>H. pylori<\/jats:italic>for clarithromycin in this northern portuguese pediatric center. This factor should determine a change in local current treatment, contraindicating the use of clarithromycin as a first\u2010line treatment for<jats:italic>H. pylori<\/jats:italic>infection in children. The high eradication rate maybe explained for the eradication treatment tailored according antimicrobial susceptibility.<\/jats:p><\/jats:sec>","DOI":"10.1111\/hel.12528","type":"journal-article","created":{"date-parts":[[2018,8,9]],"date-time":"2018-08-09T10:50:01Z","timestamp":1533811801000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":27,"title":["<i>Helicobacter pylori<\/i>antimicrobial resistance in a pediatric population"],"prefix":"10.1111","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9722-0856","authenticated-orcid":false,"given":"Gisela M.","family":"Silva","sequence":"first","affiliation":[{"name":"Pediatric Gastroenterology Unit Centro Materno\u2010Infantil do Norte Centro Hospitalar do Porto Oporto Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Helena Moreira","family":"Silva","sequence":"additional","affiliation":[{"name":"Pediatric Gastroenterology Unit Centro 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