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Clarithromycin resistance and female gender affect Helicobacter pylori eradication failure in chronic gastritis

Young Woon Chang1, Weon Jin Ko2, Chi Hyuk Oh1

  • 1Department of Internal Medicine, Kyung Hee University School of Medicine, Seoul, Korea.

The Korean Journal of Internal Medicine
|June 15, 2018
PubMed

Insights

Clarithromycin resistance and female gender significantly impact Helicobacter pylori eradication failure. This study highlights key factors influencing treatment outcomes in chronic gastritis patients.

Area of Science:

  • Gastroenterology
  • Infectious Diseases
  • Pharmacogenomics

Background:

  • First-line triple therapy for H. pylori eradication shows declining success rates in Korea.
  • Understanding factors influencing eradication failure is crucial for optimizing treatment.

Purpose of the Study:

  • To evaluate the impact of clinical parameters, clarithromycin resistance, and CYP2C19 genotype on H. pylori eradication failure.
  • To identify predictors of treatment failure for H. pylori infection.

Main Methods:

  • 203 patients with H. pylori-positive chronic gastritis received triple therapy.
  • Clarithromycin resistance was assessed via 23S rRNA point mutations.
  • CYP2C19 genotype was analyzed using PCR-RFLP.
  • Eradication was confirmed by 13C-urea breath test.

Main Results:

  • The overall eradication rate was 64.0% (ITT) and 68.4% (PP).
  • Clarithromycin resistance (17.4%) was detected, with a 0% eradication rate in these patients.
  • Clarithromycin resistance (OR, 19.13) and female gender (OR, 1.73) were significant predictors of eradication failure.
  • CYP2C19 genotype did not significantly affect eradication failure (p = 0.682).

Conclusions:

  • Clarithromycin resistance is a major factor contributing to H. pylori eradication failure.
  • Female gender is also significantly associated with treatment failure.
  • CYP2C19 genotype polymorphism did not influence the eradication outcomes in this cohort.
Abstract

Keywords:
CYP2C19 genotypeClarithromycinEradicationHelicobacter pyloriResistance

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