title: Primary Helicobacter pylori resistance to metronidazole and clarithromycin in the Finnish population.
abstract: OBJECTIVE
  To systematically determine Helicobacter pylori primary antimicrobial resistance in Finland and the associated demographic and clinical features.
  
  
  METHODS
  A total of 342 adult patients referred for gastroscopy at 23 centres in different parts of Finland and positive for the rapid biopsy urease test were recruited. Clinical and demographic data were collected via a structured questionnaire. Patients with positive H. pylori culture and successful antibiotic sensitivity determination by the E-test method (n = 292) were included in the present analysis.
  
  
  RESULTS
  The study population consisted of 134 men and 158 women, mean age 56 years (95% CI, 55-58 years). Resistance to metronidazole was 38% (110 of 292) and to clarithromycin 2% (seven of 292). Resistance to metronidazole was higher in women than in men (48% vs. 25%, P < 0.001). Previous use of antibiotics for gynaecological infections predicted metronidazole resistance (P = 0.01), and previous use of antibiotics for respiratory (P = 0.02) and dental infections (P = 0.02) the clarithromycin resistance. We observed no major geographical variations in metronidazole resistance.
  
  
  CONCLUSIONS
  The primary metronidazole resistance of H. pylori was 38% and was common in women previously treated for gynaecological infections. Primary clarithromycin resistance was uncommon (2%) and may associate with previous dental and respiratory infections.
authors.affiliation: Department of Internal Medicine, South Karelia Central Hospital, Lappeenranta, Finland. tarmo.koivisto@mbnet.fi
authors.forename: T T
authors.initials: TT
authors.lastname: Koivisto
authors.forename: H I
authors.initials: HI
authors.lastname: Rautelin
authors.forename: M E
authors.initials: ME
authors.lastname: Voutilainen
authors.forename: S E
authors.initials: SE
authors.lastname: Niemelä
authors.forename: M
authors.initials: M
authors.lastname: Heikkinen
authors.forename: P I
authors.initials: PI
authors.lastname: Sipponen
authors.forename: M A
authors.initials: MA
authors.lastname: Färkkilä
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D000890:Anti-Infective Agents / Q000627:therapeutic use*; D017291:Clarithromycin / Q000627:therapeutic use*; D024901:Drug Resistance, Multiple, Bacterial; D005260:Female; D005387:Finland / Q000453:epidemiology; D016481:Helicobacter Infections / Q000188:drug therapy* / Q000453:epidemiology; D016480:Helicobacter pylori; D006801:Humans; D008297:Male; D008795:Metronidazole / Q000627:therapeutic use*; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors
chemical_list: D000900:Anti-Bacterial Agents; D000890:Anti-Infective Agents; D008795:Metronidazole; D017291:Clarithromycin