Management of Antibiotic-Resistant Helicobacter pylori Infection: Perspectives from Vietnam

Antibiotic resistance is the most important factor leading to the failure of eradication regimens. This review focuses on the prevalence of Helicobacter pylori primary and secondary resistance to clarithromycin, metronidazole, amoxicillin, levofloxacin, tetracycline, and multidrug in Vietnam. We searched the PubMed, EMBASE, Vietnamese National Knowledge Infrastructure, and Vietnamese Biomedical databases from January 2000 to December 2016. The search terms included the following: H. pylori infection, antibiotic (including clarithromycin, metronidazole, amoxicillin, levofloxacin, tetracycline, and multidrug) resistance in Vietnam. The data were summarized in an extraction table and analyzed manually. Finally, Excel 2007 software was used to create charts. Ten studies (three studies in English and seven in Vietnamese) were included in this review. A total of 308, 412, 523, 408, 399, and 268 H. pylori strains were included in this review to evaluate the prevalence of H. pylori primary resistance to amoxicillin, clarithromycin, metronidazole, levofloxacin, tetracycline, and multidrug resistance, respectively. Overall, the primary resistance rates of amoxicillin, clarithromycin, metronidazole, levofloxacin, tetracycline, and multidrug resistance were 15.0%, 34.1%, 69.4%, 27.9%, 17.9% and 48.8%, respectively. Secondary resistance rates of amoxicillin, clarithromycin, metronidazole, levofloxacin, tetracycline, and multidrug resistance were 9.5%, 74.9%, 61.5%, 45.7%, 23.5% and 62.3%, respectively. In Vietnam, primary and secondary resistance to H. pylori is increasing over time and affects the effectiveness of H. pylori eradication.

Effect of the endoscopic treatment and the treatment with imdur for the patients with cirrhosis and high risk on digest bleed, because of oesophagus varicose

A study was carried out on 60 patients with cirrhosis at Central Military Hospital 108 between Jan 2003 and Jan 2005. The patients were divided into 2 groups corresponding to clinical and paraclinical data. Group I included 30 patient treated by ligation of esophageal varices and group II treated by Imdur. Results: The rate of bleeding and mortality after treating by ligation of esophageal varices in group I were lower than these in group II. The mortality in both groups related to bleeding. For these patients, preventive ligation of esophageal varices had effectiveness in bleeding prevention and reduced mortality risk in comparison with the treatment by Imdur .