Primary and secondary antibiotic resistance of Helicobacter pylori in Korea from 2003 to 2018

Lee, Ju Yup; Kim, Na Young; Nam, Ryoung Hee; Choi, Soo In; Lee, Jung Won; Lee, Dong Hoon

doi:10.1111/hel.12660

Cited by 63 publications

(54 citation statements)

References 56 publications

(111 reference statements)

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“…The clarithromycin resistance was greater than 15%, which is consistent with the results from recent studies conducted in Korea [ 16 , 17 ]. This high resistance is probably related to frequent use of clarithromycin for various indications, including upper or lower respiratory tract infections.…”

Section: Discussionsupporting

confidence: 92%

“…After the European Committee on Antimicrobial Susceptibility Testing (EUCAST) proposed clinical breakpoints of antibiotics for H. pylori in 2012, including tetracycline, we can now use the breakpoint of >1 mg/mL, just as in this study [ 29 ]. Accordingly, recent studies have also been reporting the increasing trend of tetracycline resistance of H. pylori with the same standards for breakpoints [ 17 , 30 ]. The tetracycline resistance more than doubled over 10 years in Korea, by the clinical breakpoint from the EUSCAST [ 31 ].…”

Section: Discussionmentioning

confidence: 99%

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The Prevalence of Multidrug Resistance of Helicobacter pylori and Its Impact on Eradication in Korea from 2017 to 2019: A Single-Center Study

Park

Shin²,

Kim

et al. 2020

Antibiotics

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Antimicrobial resistance is one of the major factors determining the efficacy of Helicobacter pylori eradication therapy. This study aimed to estimate the recent prevalence of multidrug resistance of H. pylori and its impact on eradication in Korea. A total of 174 patients were prospectively enrolled at Chung-Ang University Hospital from 2017 to 2019. H. pylori strains were isolated from the gastric body and antrum. The minimum inhibitory concentrations of antibiotics were determined by the serial twofold agar dilution method. Eradication results were reviewed and analyzed in connection with antibiotic resistance. The prevalence of H. pylori infection was 51.7% (90/174). The culture success rate was 77.8% (70/90). The resistance rates for clarithromycin, metronidazole, amoxicillin, tetracycline, levofloxacin, and moxifloxacin were 28.6% (20/70), 27.1% (19/70), 20.0% (14/70), 18.6% (13/70), 42.9% (30/70), and 42.9% (30/70), respectively. The multidrug resistance (resistance to two or more classes of antimicrobials) rate was 42.9% (30/70). Dual resistance to clarithromycin and metronidazole was confirmed in 8.6% (6/70). Eradication with a first-line treatment was successful in 75% (36/48), and those who received second-line treatment all achieved successful eradication. The rate of multidrug resistance is increasing, and standard triple therapy (STT) is no longer an acceptable first-line option for H. pylori eradication in Korea.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

The Prevalence of Multidrug Resistance of Helicobacter pylori and Its Impact on Eradication in Korea from 2017 to 2019: A Single-Center Study

Park

Shin²,

Kim

et al. 2020

Antibiotics

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“…Although resistance rate to metronidazole is over 30% in Korea, bismuth‐containing quadruple therapy is effective unless the minimum inhibitory concentration (MIC) of metronidazole exceeds 32 μg/mL . Furthermore, H. pylori resistance against tetracycline has been low and stable in Korea for the past 16 years . A recent multicenter study showed that the antibiotic resistance rate in H. pylori is lowest in Seoul .…”

Section: Introductionmentioning

confidence: 99%

“…4 Furthermore, H. pylori resistance against tetracycline has been low and stable in Korea for the past 16 years. 5 A recent multicenter study showed that the antibiotic resistance rate in H. pylori is lowest in Seoul. 6 In that study, the rate of tetracycline resistance was 0%.…”

Section: Introductionmentioning

confidence: 99%

Efficacy and safety of twice a day, bismuth‐containing quadruple therapy using high‐dose tetracycline and metronidazole for second‐line Helicobacter pylori eradication

et al. 2020

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Background/Aims Conventional second‐line, bismuth‐containing quadruple therapy is administered four times a day. We aimed to evaluate the efficacy and safety of twice a day administration compared to the four times a day therapy. Methods Medical records of consecutive patients with positive 13C‐urea breath tests (UBTs) after first‐line eradication were reviewed. From December 2018 to June 2019, 100 consecutive 13C‐UBT‐positive patients received tetracycline 1 g, metronidazole 750 mg, bismuth subcitrate 300 mg, and pantoprazole 20 mg twice a day for one week. The same number of consecutive13C‐UBT‐positive patients before December 2018 was included as controls. The control group received tetracycline 500 mg and bismuth subcitrate 300 mg four times a day, metronidazole 500 mg three times a day, and pantoprazole 20 mg twice a day for one week. Eradication was confirmed based on a 13C‐UBT performed in the 5th week after taking quadruple therapy. Results Ninety‐eight patients from the twice a day group and 99 patients from the four times a day group were analyzed. The eradication rate did not differ between the twice a day group (92/98, 93.9%) and the four times a day group (92/99, 92.9%). Adverse drug effects were found in 36 patients from the twice a day group and 50 patients from the four times a day group (P = .051). Abdominal pain, discomfort, and distention were more common with four times a day intake (13.1%) than with twice a day intake (4.1%; P = .024). Conclusions We determined for the first time that twice a day intake of bismuth‐containing quadruple therapy using 2 g/d of tetracycline, 1.5 g/d of metronidazole, and 600 mg/d of bismuth subcitrate for one week is effective and safe as the conventional four times a day therapy. Twice a day intake decreased abdominal pain, discomfort, and distention.

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“…[13][14][15] For the antibiotic resistance in H. pylori infection, bacterial culture and disc diffusion method are recommended by the Clinical Laboratory Standard Institute (CLSI). [16][17][18] However, compared with H. pylori culture, molecular pathological detection based on molecular markers, such as real-time polymerase chain reaction (PCR) and conventional PCR analysis, is a very simple and economic approach which also takes less time. Our study was designed to determine the effect and safety of H. pylori eradication therapy based on the results of molecular pathologic antibiotic resistance.…”

Section: Introductionmentioning

confidence: 99%

Eradication Treatment of Helicobacter pylori Infection Based on Molecular Pathologic Antibiotic Resistance

Gao¹,

Du²,

Long³

et al. 2020

IDR

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Background: Unfortunately, the eradication rate of Helicobacter pylori (H. pylori) treatment is markedly decreasing in recent years and the major reason is antibiotic resistance. Our study was designed to determine the effect and safety of H. pylori eradication treatment based on the molecular pathologic antibiotic resistance. Methods: 261 patients were analyzed retrospectively, including 111 patients who were treated for the first time (one group as First-treated) and 150 patients who failed at least once in bismuth quadruple therapy (another group as Re-treatment). Antibiotic resistance was examined by Real-time PCR detection and conventional PCR and sequencing method. The eradication rate (ER) was compared per intention to treat (ITT) and per protocol (PP) between the two groups. Results: The resistance rates to amoxicillin, clarithromycin, fluoroquinolone and tetracycline were 5.5%, 42.1%, 41.7% and 12.9% in the 111 first-treated patients, and 11.7%, 79.7%, 70.7% and 30.0% in the 150 re-treatment patients. The ERs in the ITT and PP analyses were 92.79% (95% CI, 87.98-97.60%, n=111) and 98.10% (95% CI, 95.48-100%, n=105), respectively, in the first-treated patients and 90.67% (95% CI, 86.01-95.32%, n=150) and 95.10% (95% CI, 91.57-98.64%, n=143), respectively, in the re-treatment patients. No significant differences were shown in the ERs between two group patients, and no serious adverse events were found. Conclusion: H. pylori eradication treatment based on molecular pathologic antibiotic resistance showed good effect and safety in both first and retreated patients.

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Primary and secondary antibiotic resistance of Helicobacter pylori in Korea from 2003 to 2018

Cited by 63 publications

References 56 publications

The Prevalence of Multidrug Resistance of Helicobacter pylori and Its Impact on Eradication in Korea from 2017 to 2019: A Single-Center Study

The Prevalence of Multidrug Resistance of Helicobacter pylori and Its Impact on Eradication in Korea from 2017 to 2019: A Single-Center Study

Efficacy and safety of twice a day, bismuth‐containing quadruple therapy using high‐dose tetracycline and metronidazole for second‐line Helicobacter pylori eradication

<p>Eradication Treatment of <em>Helicobacter pylori</em> Infection Based on Molecular Pathologic Antibiotic Resistance</p>

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