Resistance to Amoxicillin and Clarithromycin in Helicobacter pylori isolates in a tertiary care hospital

Jeyamani, Lavanya; Jayarajan, Jayalakshmi; Leelakrishnan, Ventatakrishnan; Swaminathan, Mukundan

doi:10.18231/j.ijmr.2019.063

Cited by 1 publication

(4 citation statements)

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“…The random effect (27.174%) and fixed effect (32.395%) pooled proportions (Total samples – 926) were found to be less than 50% wherein the random effect had 95% CI ranging from 11.243 to 46.940 expressing the variability of the samples in‐between the studies (Table S3). In Chennai, no amoxicillin‐resistant strains of H. pylori were observed 26 ; while Karnataka had 86.7% (98/113) 15 ; Tamil Nadu 42.3% (11/26) 21 and Hyderabad 80% (80/100) 14,26 resistance rates. In North India (Table 2), Lucknow and Delhi have shown an increase in the rate of Amx R in H. pylori from 0% in 2003 26 to 4% 23 and 17.6% 3 in 2006 and 2015 respectively whereas, the Gangetic belt has reported 65% (41/63) Amx R samples 19 .…”

Section: Resultsmentioning

confidence: 99%

“…However, only one or a few studies had reported resistance to other combinations of drugs. Low Resistance (6.5%) to the most prescribed combination of drugs that is, amoxicillin and clarithromycin, was observed in Tamil Nadu 21 . The lowest dual resistance was reported for a combination of amoxicillin and tetracycline (1.5%) in Delhi 3 .…”

Section: Discussionmentioning

confidence: 94%

“…Low Resistance (6.5%) to the most prescribed combination of drugs that is, amoxicillin and clarithromycin, was observed in Tamil Nadu. 21 The lowest dual resistance was reported for a combination of amoxicillin and tetracycline (1.5%) in Delhi. 3 Interestingly, triple-drug resistance rates are around 15.5% and are not underestimated.…”

Section: Discussionmentioning

confidence: 97%

“…Amoxicillin is another pillar of the anti‐ H. pylori triple therapy in India. High resistance against Amoxicillin occurs in certain areas (Hyderabad 19, 21 and Tamil Nadu in South India 21 ; West India; the Gangetic Belt of North India 19 ; Central India 24 ). The rest of the regions from India had reported a low to 0% resistance rate.…”

Section: Discussionmentioning

confidence: 99%

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Primary antibiotic resistance of Helicobacter pylori in India over the past two decades: A systematic review

Dutta,

Jain,

Das

et al. 2024

Helicobacter

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BackgroundHelicobacter pylori antibiotic resistance has undergone vast changes in the last two decades. No systematic review has been done on the prevalence of antibiotic resistant H. pylori in India in the last two decades. We evaluated the pattern of resistance rates across various regions of India.Materials and MethodsA systematic review of the geographical variations in antibiotic resistance pattern of H. pylori was conducted using PubMed, Google Scholar, Web of Science, Science Direct, etc. for articles published between January 1, 2000 and May 30, 2023. Random effects‐model‐based Cochran's Q test, I2 statistics, and chi‐squared tests were used to measure heterogeneity.ResultsThe overall resistance was highest against metronidazole (77.65%) followed by amoxicillin (37.78%), levofloxacin (32.8%), clarithromycin (35.64%), furazolidone (12.03%), and tetracycline (11.63%). 14.7% of the H. pylori isolates were multi‐drug resistant. Under meta‐analysis of each antibiotic, high heterogeneity levels were observed having I2 ranges from 86.53% to 97.70% at p < 0.0001. In sub‐group analysis, Metronidazole has a stable rate of resistance as compared to other antibiotics. Other antibiotics have had a downtrend in the last 5 years except for levofloxacin, which has had an uptrend in the resistance rate for the past 5 years. Hence, one should avoid using metronidazole for any kind of first‐line treatment.ConclusionsMetronidazole resistance is high in most regions of India except Assam and Mumbai while clarithromycin is found to be ineffective in South India, Gujarat, and Kashmir. As compared to other antibiotics, resistance to amoxicillin is generally low except in certain regions (Hyderabad, Chennai, and the Gangetic belt of North India). Tetracycline and Furazolidone have the least resistance rates and should be part of anti‐ H. pylori regimens. The resurgence of high single and multidrug resistance to the commonly used drugs suggests the need for newer antibiotics and regular resistance surveillance studies.

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