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Bismuth subcitrate / salicylate-based therapy is the first line for treatment of H pylori in India
Perfect Health Mela HCFI-WHO: Resistance to antibiotics for Helicobacter pylori has more than doubled in 20 years, new research presented at UEG Week Barcelona 2019 has shown.
The study analysed 1,232 patients from 18 countries across Europe and investigated resistance to antibiotics taken for H. pylori. Resistance to clarithromycin, had increased from 9.9% in 1998 to 21.6% last year, with increases in resistance also seen for levofloxacin and metronidazole.
The survey also found that the rates of primary clarithromycin resistance in H. pylori were highest in Southern Italy (39.9%), Croatia (34.6) and Greece (30%), aligning with previous reports that predict that both Italy and Greece will have the highest number of deaths due to antimicrobial resistance amongst EU members by 20507.
The rate of primary clarithromycin resistance in H. pylori in Europe in 2018 (%) found in the study was: Southern Italy (36.9), Croatia (34.6), Greece (30.0), Poland (28.5), Bulgaria (26.9), Ireland (25.6), Austria (23.5), France (22.5), Germany (22.2), Portugal (20.0), Belgium (17.4), Spain (17.1), Slovenia (16.0), Lithuania (13.0), Netherlands (9.2), Norway (8.9), Latvia (6.8) and Denmark (5.0).
H. pylori is one of the most common bacterial infections in humans and is estimated to be present in one-half of the worlds population. In 2017, the World Health Organisation identified clarithromycin-resistant H. pylori as a high priority bacterium for antibiotic research and development. With resistance rates to clarithromycin increasing at an alarming rate of nearly 1% per year, treatment options for H. pylori will become progressively limited and ineffective. (Mário Dinis-Ribeiro, President of the European Society of Gastrointestinal Endoscopy)
Bismuth subcitrate / salicylate-based therapy is the first line for treatment of H Pylori in India because of clarithromycin resistance.
However, it is not being manufactured in India currently, though it was being manufactured earlier a few years back.
It would be a great service to the patients if the DCGI or the Indian Government ensures that the Indian companies manufacture it.
(Dr Vineet Ahuja is Professor, Dept. of Gastroenterology at AIIMS Delhi)
Dr KK Aggarwal
Padma Shri Awardee
President Confederation of Medical Associations in Asia and Oceania (CMAAO)
Group Editor-in-Chief IJCP Publications
President Heart Care Foundation of India
Past National President IMA
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Indian cos should be allowed to manufactur the drug