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Updated: Feb 18, 2026
Gastric Mucosa Quantitative Polymerase Chain Reaction Analysis for Detecting Helicobacter pylori and Antibiotic Resistance
Published on: March 7, 2025
Macrolide use in the previous years is associated with failure to eradicate Helicobacter pylori with
Pablo Muñoz-Gómez1, Junior Alexander Jordán-Castro2, María Abanades-Tercero1
1Gastroenterology Department, Complejo Hospitalario de Toledo, Toledo, Spain.
Background:
There is some evidence that prior use of macrolide antibiotics is a useful predictor of the likelihood of standard triple therapy failure in Helicobacter pylori eradication. In this study, we have evaluated whether previous intake of macrolides correlates with failure to eradicate H. pylori using two different first-line clarithromycin-containing regimens.
Materials And Methods:
Retrospective study of 212 patients with H. pylori infection treated with one of two first-line clarithromycin-containing regimens: 108 patients treated with triple therapy for 10 days and 104 patients treated with concomitant therapy for 10 days. The intake of macrolides (clarithromycin, azithromycin, and other macrolides) prior to the eradication therapy was obtained from the electronic medical record, which contains information regarding all the medication prescribed to the patients since the year 2004.
Results:
One hundred of 212 patients (47.2%) had received at least one treatment with macrolides during the years prior to the eradication therapy. H. pylori eradication rates were significantly lower in patients with previous use compared to patients without previous use of macrolides, both with triple therapy (60.8% vs 92.9%; P < .0001) and with concomitant therapy (85.7% vs 98.2%; P = .024).
Conclusions:
Previous use of macrolides correlates with a low H. pylori eradication rate with triple and concomitant clarithromycin-containing regimens. In addition, our study shows that in patients without previous use of macrolides, triple therapy achieves per-protocol eradication rates over 90%.
Insights
Previous macrolide antibiotic use significantly lowers Helicobacter pylori eradication rates with standard triple or concomitant therapies. Patients without prior macrolide exposure achieved over 90% eradication with triple therapy.
Area of Science:
- Microbiology
- Infectious Diseases
- Pharmacology
Background:
- Prior macrolide antibiotic use is a potential predictor of treatment failure in Helicobacter pylori eradication.
- This study investigates the correlation between previous macrolide intake and the success of clarithromycin-based eradication regimens for H. pylori.
Purpose of the Study:
- To evaluate the impact of prior macrolide antibiotic use on H. pylori eradication rates.
- To compare the efficacy of two first-line clarithromycin-containing regimens in relation to previous macrolide exposure.
Main Methods:
- A retrospective study involving 212 patients with H. pylori infection.
- Patients received either 10-day triple therapy (108 patients) or 10-day concomitant therapy (104 patients).
- Macrolide intake history (clarithromycin, azithromycin, others) was retrieved from electronic medical records dating back to 2004.
Main Results:
- 47.2% (100/212) of patients had a history of macrolide use before eradication therapy.
- H. pylori eradication rates were significantly lower in patients with previous macrolide use compared to those without.
- Triple therapy: 60.8% vs 92.9% (P < .0001); Concomitant therapy: 85.7% vs 98.2% (P = .024).
Conclusions:
- Previous macrolide antibiotic use is associated with reduced H. pylori eradication rates for both triple and concomitant clarithromycin-containing regimens.
- In patients with no prior macrolide use, triple therapy demonstrated eradication rates exceeding 90%.
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