PubMed · 16108593
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Keizo Matsumoto. 2004. [Current viewpoint on macrolides].. https://pubmed.ncbi.nlm.nih.gov/16108593/
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Gastric infection of clarithromycin (CAM)-resistant Helicobacter pylori is one of the major causes of failure to eradicate this organism. A noninvasive and useful method for the detection of CAM-resistant H. pylori from human feces by restriction fragment length polymorphism (RFLP)-nested polymerase chain reaction (PCR) targeting the mutation of the 23S rRNA gene that confers CAM-resistance in H. pylori was developed in this study. Our nested PCR method detected DNA of H. pylori in feces with high sensitivity and specificity compared with both an enzyme-linked immunoadsorbent assay (ELISA) of H. pylori in feces and the isolation of H. pylori from gastric biopsy. Furthermore, the results of mutation analysis of the H. pylori 23S rRNA gene amplified from feces completely correlated with both that of the H. pylori 23S rRNA gene amplified from the isolates of gastric biopsy and the susceptibility of H. pylori isolates to CAM. Therefore, our results show that this RFLP/nested PCR method is useful for the accurate diagnosis of CAM-resistant H. pylori infection from feces.
Clarithromycin extended-release (ER) is a second-generation macrolide with bactericidal activity against a broad group of pathogens. It allows for convenient once-daily dosing (2 x 500 mg/day), and has less severe adverse effects than the immediate-release (IR) formulation of the drug, which may result in improved patient compliance. Clarithromycin ER has been approved for the treatment of community-acquired pneumonia, acute maxillary sinusitis and acute bacterial exacerbation of chronic bronchitis. In comparison to the IR formulation, clarithromycin ER demonstrates prolonged absorption from the gastrointestinal tract, allowing for once-daily dosing with improved gastrointestinal tolerability. Various double-blind, randomised clinical trials and group studies have found clarithromycin ER to be an efficacious treatment option, comparable with clarithromycin IR, or its other competitors.
We report on two male patients with cutaneous Mycobacterium marinum infection. After the diagnosis was established by culture, therapy with rifampicin and clarithromycin over a period of three months led to remarkable improvement.