Clinical Characteristicsof Patients with Failed Eradication of Helicobacter pylori and Antibiotic Resistance

Yoo, Hyo Min; Lee, Yong Chan; Park, Hyo Jin; Kim, Won Ho; Lee, Kyung Won; Park, In Suh

Abstract

BACKGROUND/AIMS: The decisive factors influencing the eradication of H. pylori still remain unclear To identify such factors, we investigated the clinical characteristics and antibiotic resistance of patients.
METHODS
Patients with H. pylori infection were treated with dual or triple regimens. Eradi cation rates were analyzed on the basis of clinical factors, endoscopic factors and antibiotic resistance
RESULTS
Sixty-three H. pylori infected patients were enrolled (mean age 49.4). The eradication rate was significantly higher in compliant patients (71.9%) than in non-compliant patients (20%). Other clinical and endoscopic factors did not significantly influence the outcome of treatment. In 42 isolated strains, metronidazole resistance (MIC>8 microgram/mL) was observed in 35.7% of the strains and clari thromycin resistance (MIC>2 microgram/mL) was observed in 7.1%. The eradication rate in metronidazole resistant strains was 55.5%, which was lower than that in metronidazole sensitive strains (78.6%) The median value of metronidazole MIC in the group of successful eradication (0.94 microgram/mL) was significantly lower than that in the group of failed eradication (64.0 microgram/mL).
CONCLUSIONS
Patient' s compliance for regimens seems to be the most important factor which affect H. pylori eradication Metronidazole resistance which is highly prevalent in our population may influence the efficacy of anti-H. pylori treatment regimen containing metronidazole.