title: [Low prevalence of metronidazole- and clarithomycin-resistant Helicobacter pylori in the 's-Hertogenbosch region, 1998-2003].
abstract: OBJECTIVE
  To measure the prevalence of metronidazole- or clarithromycin-resistant Helicobacter pylori. DESIGN. Retrospective.
  
  
  METHODS
  All positive H. pylori cultures with known susceptibility to metronidazole or clarithromycin between 1998 and 2003 were selected from the database of the Microbiology Laboratory in 's-Hertogenbosch, the Netherlands. Resistance to clarithromycin and metronidazole was determined using the E-test with cut-off minimum inhibitory concentrations of > or = 2 microg/ml and > or = 8 microg/ml, respectively.
  
  
  RESULTS
  Of the 960 cultures with known metronidazole susceptibility, 135 (14%) were resistant. Of the 959 cultures with known clarithromycin susceptibility, 26 (3%) were resistant. The percentages of resistant cultures were higher in women than in men (17% versus 12% and 4% versus 2%, respectively). There was no relationship between age and resistance. Over the course of the study period, resistance to metronidazole decreased slightly, whereas resistance to clarithromycin increased slightly.
  
  
  CONCLUSIONS
  Prevalence of metronidazole- and clarithromycin-resistant H. pylori strains in the 's-Hertogenbosch region was so low that the combination of a proton pump inhibitor, clarithromycin and amoxicillin can be used in patients with H. pylori infection without first determining susceptibility.
authors.affiliation: Universitair Medisch Centrum St Radboud, afd Maag-, Darm- en Leverziekten, Nijmegen. marceljanssen6@hotmail.com
authors.forename: M J R
authors.initials: MJ
authors.lastname: Janssen
authors.forename: P M
authors.initials: PM
authors.lastname: Schneeberger
authors.forename: W A
authors.initials: WA
authors.lastname: de Boer
authors.forename: R J F
authors.initials: RJ
authors.lastname: Laheij
authors.forename: J B M J
authors.initials: JB
authors.lastname: Jansen
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D017291:Clarithromycin / Q000494:pharmacology*; D004305:Dose-Response Relationship, Drug; D024901:Drug Resistance, Multiple, Bacterial; D005260:Female; D016480:Helicobacter pylori / Q000187:drug effects*; D006801:Humans; D008297:Male; D008795:Metronidazole / Q000494:pharmacology*; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D009426:Netherlands; D015995:Prevalence; D012189:Retrospective Studies; D012737:Sex Factors; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D008795:Metronidazole; D017291:Clarithromycin