title: The relationship between the failure to eradicate Helicobacter pylori and previous antibiotics use.
abstract: BACKGROUND
  The previous use of antibiotics is known to correlate positively with antibiotic resistance; whether this is also the case in the eradication of Helicobacter pylori infection is unclear.
  
  
  OBJECTIVE
  To investigate the relationship between the previous use of antibiotics and the failure of eradication therapy in H. pylori infection.
  
  
  METHODS
  The relationship between the clinical parameters and the failure of H. pylori eradication was analyzed in patients administered standard triple therapy and then assessed for the eradication of H. pylori based on a C13-urea breath test.
  
  
  RESULTS
  In a multivariate analysis, failure rates increased significantly in patients with a history of clarithromycin (odds ratio [OR], 4.445) or other macrolides (OR, 2.407) use, who were female (OR, 1.339), or who were older than 60 years of age (OR, 1.326). The eradication failure rate in patients with a history of macrolides use for >2 weeks was significantly higher than if the duration of use was <2 weeks (44.8% vs. 29.3%, p=0.047).
  
  
  CONCLUSIONS
  A patient's history of macrolides is a useful predictor of the likelihood of standard triple therapy failure in H. pylori eradication. The alternatives such as a bismuth-based quadruple or a levofloxacin-containing therapy should be considered in patients treated with macrolides for >2 weeks.
authors: Department of Gastroenterology, Ajou University School of Medicine, Suwon, South Korea.
authors: Sun Gyo
authors: SG
authors: Lim
authors: Department of Biomedical Informatics, Ajou University School of Medicine, Suwon, South Korea.
authors: Rae Woong
authors: RW
authors: Park
authors: Department of Gastroenterology, Ajou University School of Medicine, Suwon, South Korea.
authors: Sung Jae
authors: SJ
authors: Shin
authors: Department of Biomedical Informatics, Ajou University School of Medicine, Suwon, South Korea.
authors: Dukyong
authors: D
authors: Yoon
authors: Department of Gastroenterology, Ajou University School of Medicine, Suwon, South Korea.
authors: Joon Koo
authors: JK
authors: Kang
authors: Department of Gastroenterology, Ajou University School of Medicine, Suwon, South Korea.
authors: Jae Chul
authors: JC
authors: Hwang
authors: Department of Gastroenterology, Ajou University School of Medicine, Suwon, South Korea.
authors: Soon Sun
authors: SS
authors: Kim
authors: Department of Gastroenterology, Ajou University School of Medicine, Suwon, South Korea.
authors: Jin Hong
authors: JH
authors: Kim
authors: Department of Gastroenterology, Ajou University School of Medicine, Suwon, South Korea. Electronic address: lkm5104@aumc.ac.kr.
authors: Kee Myung
authors: KM
authors: Lee
mesh_terms: D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D001729:Bismuth / Q000627:therapeutic use; D001944:Breath Tests; D017291:Clarithromycin / Q000008:administration & dosage*; D024881:Drug Resistance, Bacterial; D005260:Female; D016481:Helicobacter Infections / Q000188:drug therapy*; D016480:Helicobacter pylori / Q000187:drug effects*; D006784:Hospitals, Teaching; D006801:Humans; D064704:Levofloxacin / Q000627:therapeutic use; D016015:Logistic Models; D018942:Macrolides / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D056910:Republic of Korea; D012189:Retrospective Studies; D062606:Tertiary Care Centers
chemical_list: D000900:Anti-Bacterial Agents; D018942:Macrolides; D064704:Levofloxacin; D017291:Clarithromycin; D001729:Bismuth
keywords: Clarithromycin; Drug resistance; Helicobacter pylori; Macrolides; Microbial