Antimicrobial resistance of Helicobacter pylori affects the efficacy of eradication therapy.
Dr Jung Won Lee and colleagues from Korea estimated the prevalence of primary and secondary resistance of H. pylori isolates to antibiotics and to characterize the risk factors associated with antimicrobial resistance in Korea.
The team evaluated data during the period of 2003–2012.
Primary resistance was evaluated from 347 patients without any history of eradication, and secondary resistance was evaluated in 86 patients from whom H. pylori was cultured after failure of eradication.
Minimal inhibitory concentration test was performed for amoxicillin, clarithromycin, metronidazole, tetracycline, azithromycin, levofloxacin, and moxifloxacin using agar dilution method.
The doctors evaluated primary and secondary resistance rates of H. pylori to 7 antibiotics, and risk factors for the antibiotic resistance were analyzed.
Increase in the primary resistance rate was found in amoxicillin, clarithromycin, and both of levofloxacin and moxifloxacin during the study period.
|Secondary resistance rate significantly increased in metronidazole|
The researchers noted that secondary resistance rate significantly increased in metronidazole, levofloxacin, and moxifloxacin.
Increase of resistance occurred after initial failure of eradication therapy in case of clarithromycin, azithromycin, levofloxacin, and moxifloxacin.
The doctors showed that clarithromycin, azithromycin, levofloxacin, and moxifloxacin resistance was associated with previous eradication treatment history.
Dr Lee's team concluded "The increased primary and secondary antibiotic resistance of H. pylori in Korea is ongoing, and it will become a significant limitation for effective eradication of H. pylori in the future."