{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,13]],"date-time":"2025-12-13T10:52:09Z","timestamp":1765623129649,"version":"3.48.0"},"reference-count":20,"publisher":"BMJ","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Gut"],"published-print":{"date-parts":[[1995,5]]},"abstract":"<jats:p>Treatment of Helicobacter pylori infection with amoxycillin is known to reduce the bacterial load to undetectable levels, while not eradicating the infection. It seems, therefore, that bacteria escape treatment at a 'sanctuary site'. This study examined whether such a site existed in the gastric antrum, body, or fundus. Twenty two patients with H pylori infection and duodenal ulcer disease were treated for one week with amoxycillin (500 mg three times a day) and cimetidine (800 mg at night). Before treatment, H pylori was detected throughout all stomachs, and 13C-urea breath testing at least 28 days after treatment confirmed that eradication of H pylori had occurred in no patients. While under treatment, H pylori was sought by conventional methods and by polymerase chain reaction assay and was found in the gastric fundus in 13 of 22 subjects, in the body in 10 of 22, and the antrum in three of 22: the difference between fundus and antrum was significant (p &lt; 0.01). The continued antral infection in three subjects may have resulted from generalised treatment failure as two of three had H pylori detected throughout the stomach, and these two had compiled relatively poorly with treatment. This study suggests that amoxycillin and cimetidine are relatively effective at clearing H pylori from the gastric antrum, but that escape from treatment may occur in the gastric body, and especially the fundus.<\/jats:p>","DOI":"10.1136\/gut.36.5.670","type":"journal-article","created":{"date-parts":[[2007,9,18]],"date-time":"2007-09-18T17:41:31Z","timestamp":1190137291000},"page":"670-674","source":"Crossref","is-referenced-by-count":38,"title":["Detection of the intragastric sites at which Helicobacter pylori evades treatment with amoxycillin and cimetidine."],"prefix":"10.1136","volume":"36","author":[{"given":"J C","family":"Atherton","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A","family":"Cockayne","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M","family":"Balsitis","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G E","family":"Kirk","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C J","family":"Hawkey","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R C","family":"Spiller","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[1995,5,1]]},"reference":[{"key":"ref_1","first-page":"1552","article-title":"The whos and whens of therapy for Helicobacter pylori","volume":"85","author":"Graham, D.Y.; Borsch, G.M.A.","year":"1990","unstructured":"Graham DY, Borsch GMA. The whos and whens of therapy for Helicobacter pylori. Am J Gastroenterol 1990; 85: 1552-5.","journal-title":"Am J Gastroenterol"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1167","DOI":"10.1136\/gut.34.9.1167","article-title":"Amoxycillin plus omeprazole versus triple therapy for eradication of Helicobacter pylori in duodenal ulcer disease: a prospective, randomized and controlled study","volume":"34","author":"Labenz, J.; Gyenes, E.; Ruhl, G.H.; Borsch, G.","year":"1993","unstructured":"Labenz J, Gyenes E, Ruhl GH, Borsch G. Amoxycillin plus omeprazole versus triple therapy for eradication of Helicobacter pylori in duodenal ulcer disease: a prospective, randomized and controlled study. Gut 1993; 34: 1167-70.","journal-title":"Gut"},{"key":"ref_3","first-page":"751","article-title":"Omeprazole plus antibiotic combinations for the eradication of metronidazole-resistant Helicobacter pylori","volume":"6","author":"Bell, G.D.; Powell, K.U.; Burridge, S.M.; Spencer, G.; Bolton, G.; Purser, K.","year":"1992","unstructured":"Bell GD, Powell KU, Burridge SM, Spencer G, Bolton G, Purser K, et al. Omeprazole plus antibiotic combinations for the eradication of metronidazole-resistant Helicobacter pylori. Alimentary Pharmacology and Therapeutics 1992; 6: 751-8.","journal-title":"Alimentary Pharmacology and Therapeutics"},{"key":"ref_4","first-page":"313","article-title":"Short report: high dose omeprazole and amoxycillin in the treatment of Helicobacter pylori-associated duodenal ulcer","volume":"7","author":"Collins, R.; Beattie, S.; Xia, H.X.; O'Morain, C.","year":"1993","unstructured":"Collins R, Beattie S, Xia HX, O'Morain C. Short report: high dose omeprazole and amoxycillin in the treatment of Helicobacter pylori-associated duodenal ulcer. Alimentary Pharmacology and Therapeutics 1993; 7: 313-5.","journal-title":"Alimentary Pharmacology and Therapeutics"},{"key":"ref_5","first-page":"183","article-title":"Omeprazole and amoxycillin in patients with duodenal ulcer: Helicobacter pylori eradication and remission of ulcers and symptoms during","volume-title":"a 6-month follow-up. Gastroenterology 1992; 102","author":"Unge, P.; Eriksson, K.; Bergman, B.; Carling, L.; Ekstrom, P.; Gad, A.","unstructured":"Unge P, Eriksson K, Bergman B, Carling L, Ekstrom P, Gad A, et al. Omeprazole and amoxycillin in patients with duodenal ulcer: Helicobacter pylori eradication and remission of ulcers and symptoms during a 6-month follow-up. Gastroenterology 1992; 102: A183."},{"key":"ref_6","first-page":"149","article-title":"Two week eradication regimen for metronidazole resistant Helicobacter pylori","volume":"7","author":"Logan, R.P.; Gummett, P.A.; Misiewicz, J.J.; Karim, Q.M.; Walker, M.M.; Baron, J.H.","year":"1993","unstructured":"Logan RP, Gummett PA, Misiewicz JJ, Karim QM, Walker MM, Baron JH. Two week eradication regimen for metronidazole resistant Helicobacter pylori. Alimentary Pharmacology and Therapeutics 1993; 7: 149-53.","journal-title":"Alimentary Pharmacology and Therapeutics"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"503","DOI":"10.1111\/j.1365-2036.1992.tb00564.x","article-title":"Short report: cefprozil for the eradication of Helicobacter pylori","volume":"6","author":"Malaty, H.; Klein, P.D.; Graham, D.Y.","year":"1992","unstructured":"Malaty H, Klein PD, Graham DY. Short report: cefprozil for the eradication of Helicobacter pylori. Alimentary Pharmacology and Therapeutics 1992; 6: 503-6.","journal-title":"Alimentary Pharmacology and Therapeutics"},{"key":"ref_8","first-page":"365","article-title":"Campylobacter pylori-association gastritis: A double-blind placebo-controlled trial with amoxycillin","volume":"83","author":"Glupczynski, Y.; Burette, A.; Labbe, M.; Deprez, C.; DeReuck, M.; Deltenre, M.","year":"1988","unstructured":"Glupczynski Y, Burette A, Labbe M, Deprez C, DeReuck M, Deltenre M. Campylobacter pylori-association gastritis: A double-blind placebo-controlled trial with amoxycillin. Am Jf Gastroenterol 1988; 83: 365-71.","journal-title":"Am Jf Gastroenterol"},{"key":"ref_9","first-page":"33","article-title":"Campylobacter pyloridis-associated chronic active antral gastritis. A prospective study of its prevalence and the effects of anti-bacterial","volume-title":"and anti-ulcer treatment. Gastroenterology 1988; 94","author":"Rauws, E.A.J.; Langenburg, W.; Houthoff, H.J.; Zanen, H.C.; Tytgat, G.N.J.","unstructured":"Rauws EAJ, Langenburg W, Houthoff HJ, Zanen HC, Tytgat GNJ. Campylobacter pyloridis-associated chronic active antral gastritis. A prospective study of its prevalence and the effects of anti-bacterial and anti-ulcer treatment. Gastroenterology 1988; 94: 33-40."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"783","DOI":"10.1128\/JCM.31.4.783-787.1993","article-title":"Detection of Helicobacter pylori in dental plaque by reverse transcription-polymerase chain reaction","volume":"31","author":"Nguyen, A.-M.H.; Engstrand, L.; Genta, R.M.; Graham, D.Y.; ElZaatari, F.A.K.","year":"1993","unstructured":"Nguyen A-MH, Engstrand L, Genta RM, Graham DY, ElZaatari FAK. Detection of Helicobacter pylori in dental plaque by reverse transcription-polymerase chain reaction. Jf Clin Microbiol 1993; 31: 783-7.","journal-title":"Jf Clin Microbiol"},{"issue":"142","key":"ref_11","first-page":"25","article-title":"Pathogenetic implications of ultrastructural findings in Campylobacter pylori related gastroduodenal disease","volume":"23","author":"Bode, G.; Malfertheiner, P.; Ditschuneit, H.","year":"1988","unstructured":"Bode G, Malfertheiner P, Ditschuneit H. Pathogenetic implications of ultrastructural findings in Campylobacter pylori related gastroduodenal disease. Scand Jf Gastroenterol 1988; 23 (suppl 142): 25-39.","journal-title":"Scand Jf Gastroenterol"},{"key":"ref_12","first-page":"1348","article-title":"Campylobacter-like organisms in the stomach of patients and healthy individuals","volume":"i:","author":"Langenberg, M.-L.; Tytgat, G.N.J.; Schipper, M.E.I.; Rietra, P.J.G.M.; Zanen, H.C.","year":"1984","unstructured":"Langenberg M-L, Tytgat GNJ, Schipper MEI, Rietra PJGM, Zanen HC. Campylobacter-like organisms in the stomach of patients and healthy individuals. Lancet 1984; i: 1348.","journal-title":"Lancet"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"192","DOI":"10.1128\/JCM.30.1.192-200.1992","article-title":"Sensitive detection of Helicobacter pylori by using polymerase chain reaction","volume":"30","author":"Clayton, C.L.; Kleanthous, H.; Coates, P.J.; Morgan, D.D.; Tabaqchali, T.","year":"1992","unstructured":"Clayton CL, Kleanthous H, Coates PJ, Morgan DD, Tabaqchali T. Sensitive detection of Helicobacter pylori by using polymerase chain reaction. Jf Clin Microbiol 1992; 30: 192-200.","journal-title":"Jf Clin Microbiol"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"2543","DOI":"10.1128\/JCM.29.11.2543-2549.1991","article-title":"Direct polymerase chain reaction test for detection of Helicobacter pylori in humans and animals","volume":"29","author":"Ho, S.-A.; Hoyle, J.A.; Lewis, F.A.; Secker, A.D.; Cross, D.; Mapstone, N.P.","year":"1991","unstructured":"Ho S-A, Hoyle JA, Lewis FA, Secker AD, Cross D, Mapstone NP, et al. Direct polymerase chain reaction test for detection of Helicobacter pylori in humans and animals. 7 Clin Microbiol 1991; 29: 2543-9.","journal-title":"7 Clin Microbiol"},{"key":"ref_15","first-page":"915","article-title":"The European '3C-urea breath test for the detection of Helicobacter pylori","volume-title":"European Journal of Gastroenterology and Hepatology 1991; 3","author":"Logan, R.P.H.; Dill, S.; Bauer, F.E.; Walker, M.M.; Hirscl, M.M.; Gummett, P.A.","unstructured":"Logan RPH, Dill S, Bauer FE, Walker MM, Hirscl MM, Gummett PA, et al. The European '3C-urea breath test for the detection of Helicobacter pylori. European Journal of Gastroenterology and Hepatology 1991; 3: 915-26."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"900","DOI":"10.1016\/0140-6736(93)93112-E","article-title":"Detection of Helicobacter pylori DNA by PCR in gastrointestinal equipment","volume":"341","author":"Roosendaal, R.; Kuipers, E.J.; van den Brule, A.J.C.; Pena, A.S.; Meuwissen, S.G.; Walboomers, J.M.","year":"1993","unstructured":"Roosendaal R, Kuipers EJ, van den Brule AJC, Pena AS, Meuwissen SG, Walboomers, JM, et al. Detection of Helicobacter pylori DNA by PCR in gastrointestinal equipment. Lancet 1993; 341: 900.","journal-title":"Lancet"},{"key":"ref_17","first-page":"555","article-title":"Adherent and soluble mucus in the stomach and duodenum","volume":"30","author":"Allen, A.; Carroll, N.J.H.","year":"1985","unstructured":"Allen A, Carroll NJH. Adherent and soluble mucus in the stomach and duodenum. Dig Dis Sci 1985; 30: 555-625.","journal-title":"Dig Dis Sci"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"727","DOI":"10.1136\/jcp.42.7.727","article-title":"Campylobacter pylori infection in biopsy specimens of gastric antrum: laboratory diagnosis and estimation of sampling error","volume":"42","author":"Morris, A.; Ali, M.R.; Brown, P.; Lane, M.; Patton, K.","year":"1989","unstructured":"Morris A, Ali MR, Brown P, Lane M, Patton K. Campylobacter pylori infection in biopsy specimens of gastric antrum: laboratory diagnosis and estimation of sampling error. Jf Clin Pathol 1989; 42: 727-32.","journal-title":"Jf Clin Pathol"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"834","DOI":"10.1136\/jcp.42.8.834","article-title":"Topographic association between active gastritis and Campylobacter pylori colonisation","volume":"42","author":"Bayerdorffer, E.; Oertel, H.; Lehn, N.; Kasper, G.; Mannes, G.A.; Sauerbruch, T.","year":"1989","unstructured":"Bayerdorffer E, Oertel H, Lehn N, Kasper G, Mannes GA, Sauerbruch T, et al. Topographic association between active gastritis and Campylobacter pylori colonisation. Jf Clin Pathol 1989; 42: 834-39.","journal-title":"Jf Clin Pathol"},{"key":"ref_20","article-title":"Luminal amoxycillin determines gastric mucosal concentrations","author":"Lambert, JR, Lancer; B, Schenbin; MA, King; R, Tumbridge; J.","year":"1992","unstructured":"Lambert JR, Lancer B, Schenbin MA, King R, Tumbridge J. Luminal amoxycillin determines gastric mucosal concentrations. Gastroenterology 1992; 100 (5): A104.","journal-title":"Gastroenterology"}],"container-title":["Gut"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/gut.36.5.670","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,13]],"date-time":"2025-12-13T10:47:58Z","timestamp":1765622878000},"score":1,"resource":{"primary":{"URL":"https:\/\/gut.bmj.com\/lookup\/doi\/10.1136\/gut.36.5.670"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1995,5]]},"references-count":20,"journal-issue":{"issue":"5","published-online":{"date-parts":[[1995,5,1]]},"published-print":{"date-parts":[[1995,5]]}},"alternative-id":["10.1136\/gut.36.5.670"],"URL":"https:\/\/doi.org\/10.1136\/gut.36.5.670","relation":{},"ISSN":["0017-5749","1468-3288"],"issn-type":[{"type":"print","value":"0017-5749"},{"type":"electronic","value":"1468-3288"}],"subject":[],"published":{"date-parts":[[1995,5]]}}}