Title |
Second-line therapy for Helicobacter pylori eradication causing antibiotic-associated hemorrhagic colitis
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Published in |
Annals of Clinical Microbiology and Antimicrobials, August 2017
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DOI | 10.1186/s12941-017-0230-0 |
Pubmed ID | |
Authors |
Kazuyuki Tanaka, Mikihiro Fujiya, Aki Sakatani, Shugo Fujibayashi, Yoshiki Nomura, Nobuhiro Ueno, Shin Kashima, Takuma Goto, Junpei Sasajima, Kentaro Moriichi, Toshikatsu Okumura |
Abstract |
Helicobacter pylori (H. pylori) eradication rarely develops into antibiotic-associated hemorrhagic colitis (AAHC), in which the etiology of colitis remains unclear. We herein report a rare case of AAHC caused by second-line therapy for H. pylori eradication. A 65-year-old female was administered second-line therapy for H. pylori composed of 1500 mg of amoxicillin, 500 mg of metronidazole and 40 mg of vonoprazan for 7 days because of first-line therapy failure. A day after completing second-line therapy, she complained of abdominal pain and hematochezia. Colonoscopy revealed a hemorrhage and edematous mucosa with no transparent vascular pattern in the transverse colon. A bacterial culture detected Klebsiella oxytoca (K. oxytoca), but no other pathogenic bacteria. A drug-induced lymphocyte stimulation test (DLST) showed positive reactions for both amoxicillin and metronidazole. According to these findings, the patient was diagnosed with AAHC. Bowel rest for 6 days relieved her abdominal pain and hematochezia. The present case developed AAHC caused by second-line therapy for H. pylori eradication. The pathogenesis is considered to be associated with microbial substitution as well as a delayed-type allergy to antibiotics, suggesting that AAHC is a potential adverse event of second-line therapy for H. pylori eradication. |
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Venezuela, Bolivarian Republic of | 1 | 100% |
Demographic breakdown
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Scientists | 1 | 100% |
Mendeley readers
Geographical breakdown
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Unknown | 23 | 100% |
Demographic breakdown
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Researcher | 4 | 17% |
Student > Bachelor | 3 | 13% |
Student > Master | 3 | 13% |
Student > Ph. D. Student | 2 | 9% |
Other | 2 | 9% |
Other | 2 | 9% |
Unknown | 7 | 30% |
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Immunology and Microbiology | 3 | 13% |
Nursing and Health Professions | 2 | 9% |
Business, Management and Accounting | 2 | 9% |
Social Sciences | 1 | 4% |
Other | 1 | 4% |
Unknown | 6 | 26% |