Professor Sibylle Koletzko and colleagues from Germany prospectively assessed the antibacterial resistance rate in Helicobacter pylori strains.
During a 4-year period, 17 pediatric centers from 14 European countries reported prospectively on symptomatic children infected with H pylori.
Antibiotic susceptibility was tested in all of these children.
A total of 1233 patients were identified.
The researchers noted that 3% were from North Europe, and 70% from Western Europe.
The team identified 9% from Eastern Europe, and 18% from Southern Europe.
The research team observed that 41% originated from outside Europe as indicated by mother's birth-country.
The researchers found that 13% were under the age of 6 years, 43% were between 6 and 11 years of age, and 44% were over 11 years of age.
Testing was carried out before the first treatment in 1037 patients in Group 1.
The team carried out testing after treatment failure in 196 patients in Group 2.
| Overall resistance rate to metronidazole was 25%|
Overall resistance to clarithromycin was detected in 24%.
The researchers found that primary clarithromycin resistance rate was higher in boys.
Primary clarithromycin resistance was also higher in children under the age of 6 years.
The team noted that primary clarithromycin resistance was higher in those living in Southern Europe compared with those living in Northern Europe.
Overall resistance rate to metronidazole was 25%, and higher in children born outside Europe.
The researchers found that resistance to both antibiotics occurred in 7%.
Resistance to amoxicillin was exceptional.
In addition, the research team observed that children with peptic ulcer disease were older than patients without ulcer.
Professor Koletzko's team concludes, “The primary resistance rate of H pylori strains obtained from unselected children in Europe is high.”
“The use of antibiotics for other indications seems to be the major risk factor for development of primary resistance.”