Antibiotic resistance in Helicobacter pylori

Abstract

Objective: To describe antibiotic resistance patterns in Helicobacter pylori.

Design: Culture and antibiotic sensitivity testing of antral and gastric body biopsy samples from patients having gastroscopy.

Participants: Consecutive consenting patients aged 18 years or more presenting for gastroscopy from 1 July 1998 to 30 June 1999.

Setting: An open-access gastroscopy service at an urban university tertiary hospital.

Main outcome measures: Number of H. pylori isolates showing resistance to antibiotics; correlates of such resistance with demographic and clinical information.

Results: Of 1580 patients undergoing endoscopy, 434 agreed to participate in the study. 108 (24.9%) had positive cultures for H. pylori, and 88 of these isolates (81%) were available for further testing. Resistance to metronidazole and clarithromycin was detected in 36% and 11%, respectively. No resistance was found to tetracycline or amoxycillin. Metronidazole resistance was commoner in younger patients (P = 0.0004) and macrolide resistance was commoner in those born outside Australia or New Zealand (P = 0.03).

Conclusions: We found substantial resistance to metronidazole, and emerging clarithromycin resistance, but complete susceptibility to amoxycillin, tetracycline, gentamicin and cefaclor. These factors may influence the effectiveness of presently recommended eradication regimens.