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Gastric Mucosa Quantitative Polymerase Chain Reaction Analysis for Detecting Helicobacter pylori and Antibiotic Resistance
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Effects of prior antibiotic use on clarithromycin resistance in Helicobacter pylori

Young-Min Kwon1, Sung-Jae Kim1, Jae Gon Lee2

  • 1Department of Orthopaedic Surgery, Hallym University Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, South Korea.

Helicobacter
|March 28, 2023
PubMed
Abstract

Insights

Previous macrolide antibiotic use significantly increases clarithromycin resistance in Helicobacter pylori (H. pylori) infections. Respiratory comorbidities also elevate H. pylori resistance rates, impacting treatment effectiveness.

Area of Science:

  • Microbiology and Infectious Diseases
  • Pharmacology and Therapeutics
  • Public Health and Epidemiology

Background:

  • Macrolide antibiotics are crucial for treating infections like pneumonia and sinusitis.
  • Prior macrolide exposure is suspected to reduce the efficacy of standard triple therapy for Helicobacter pylori (H. pylori) eradication.

Purpose of the Study:

  • To investigate the impact of previous macrolide antibiotic usage on clarithromycin resistance in H. pylori.
  • To identify risk factors associated with clarithromycin resistance in H. pylori infections.

Main Methods:

  • Analysis of a Korean National Health Insurance Service database (2016-2019) including 46,160 patients tested for H. pylori clarithromycin resistance.
  • Investigation of patient antibiotic history (past 10 years) and respiratory comorbidity history (past 1 year).

Main Results:

  • The overall clarithromycin resistance rate for H. pylori in Korea was 16.2%.
  • Multivariate analysis identified female sex, age over 50, previous macrolide use (clarithromycin, azithromycin, erythromycin, roxithromycin), and respiratory comorbidities (sinusitis, laryngopharyngitis, bronchitis, pneumonia) as independent risk factors for H. pylori clarithromycin resistance.

Conclusions:

  • Previous macrolide antibiotic use is a significant risk factor for developing clarithromycin resistance in H. pylori.
  • Recent respiratory diseases may also contribute to increased H. pylori clarithromycin resistance, highlighting the need for judicious antibiotic prescribing.
Keywords:
Helicobacter pyloriantibioticsdrug resistance

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