Antibiotic resistance in Helicobacter pylori.
OBJECTIVE
To describe antibiotic resistance patterns in Helicobacter pylori.


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


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


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


METHODS
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.
Mollison
L C
LC
Department of Medicine, University of Western Australia. lindsay.mollison@health.wa.gov.au
Stingemore
N
N
Wake
R A
RA
Cullen
D J
DJ
McGechie
D B
DB
D000900:Anti-Bacterial Agents / Q000494:pharmacology* / Q000627:therapeutic use; D017291:Clarithromycin / Q000494:pharmacology* / Q000627:therapeutic use; D004352:Drug Resistance, Microbial; D005260:Female; D005773:Gastroscopy; D016481:Helicobacter Infections / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology* / Q000473:pathology; D016480:Helicobacter pylori / Q000187:drug effects* / Q000302:isolation & purification; D006801:Humans; D008297:Male; D008795:Metronidazole / Q000494:pharmacology* / Q000627:therapeutic use; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D011446:Prospective Studies; D013272:Stomach Diseases / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology* / Q000473:pathology; D014904:Western Australia / Q000453:epidemiology
D000900:Anti-Bacterial Agents; D008795:Metronidazole; D017291:Clarithromycin