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News

Antimicrobial surveillance in idiopathic Parkinsonism

A study in this month's issue of Helicobacter reports indication-specific improvement in hypokinesia following H pylori eradication, and non-specific effect of antimicrobials for other indications in worsening rigidity in Parkinsonism.

News image

Following Helicobacter pylori eradication in a placebo-controlled trial, the hypokinesia of idiopathic parkinsonism improved but flexor rigidity worsened.

Dr Sylvia Dobbs and the colleagues from the United Kingdom surveyed the effect of all antimicrobial prescriptions in 66 patients with idiopathic parkinsonism over a median of 1.9 years.

The team reported that initial Helicobacter screening was followed by gastric biopsy.

Serial lactulose hydrogen breath tests for small intestinal bacterial overgrowth monitored the need to encourage fluid intake and bulk/osmotic laxatives.

The team of doctors noted that they measured hypokinesia and upper limb flexor rigidity.

Following successful H. pylori eradication but not failed, stride increased in entire group, core group and untreated.

The effect was greater with less antiparkinsonian medication.

40 out of 66 were lactulose hydrogen breath test positive
Helicobacter

The research team found that flexor rigidity was unchanged.

Following antimicrobials for other indications, hypokinesia was unchanged.

However, the team noted that flexor rigidity increased cumulatively.

The doctors reported that initially, 40 out of 66 were lactulose hydrogen breath test positive.

Odds for positivity fell with time and tended to be lower with Helicobacter positivity, but were unrelated to other antimicrobial interventions.

Dr Dobbs's team commented, "Improved hypokinesia following antimicrobials appeared unique to Helicobacter eradication."

"Rigidity increased following successive antimicrobial exposures for other indications, despite diminishing lactulose hydrogen breath test positivity."

Helicobacter 2013:18(3) :187–196
11 June 2013

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