Second-line therapy for Helicobacter pylori eradication causing antibiotic-associated hemorrhagic colitis
著者
田中, 一之
(Tanaka, Kazuyuki)
藤谷, 幹浩
(Fujiya, Mikihiro)
坂谷, 慧
(Sakatani, Aki)
藤林, 周吾
(Fujibayashi, Shugo)
野村, 好紀
(Nomura, Yoshiki)
上野, 伸展
(Ueno, Nobuhiro)
嘉島, 伸
(Kashima, Shin)
後藤, 拓磨
(Goto, Takuma)
笹島, 順平
(Sasajima, Junpei)
盛一, 健太郎
(Moriichi, Kentaro)
奥村, 利勝
(Okumura, Toshikatsu)
上位タイトル
Annals of Clinical Microbiology and Antimicrobials
Vol.16,
No.1
(2017.
8)
,p.54-
識別番号
ISSN
1476-0711
DOI
10.1186/s12941-017-0230-0
その他
PMID：28806959
抄録
OBJECTIVE:
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.
RESULTS:
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.
CONCLUSIONS:
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.
