Korean J Helicobacter Up Gastrointest Res.  2011 Jun;11(1):13-20. 10.7704/kjhugr.2011.11.1.13.

Antibiotic Resistance in Helicobacter pylori Infection

• Kim JG
• Kim BJ

• KMID: 2305184
• DOI: http://doi.org/10.7704/kjhugr.2011.11.1.13

Abstract

Helicobacter pylori (H. pylori) causes chronic gastritis, peptic ulcer disease, primary B-cell gastric lymphoma, and adenocarcinoma of the stomach. The eradication of H. pylori infection requires combination of antibiotics including proton pump inhibitors. However, development of antibiotic resistance is a major cause of treatment failure. To select an appropriate regimen, systemic information on the antibiotic resistance is mandatory. H. pylori acquires resistance essentially via point mutations, and this phenomenon is found with most antibacterials. The prevalence of primary antibiotic resistance in H. pylori strains isolated from Korean patients has been increasing along with the shift to high minimum inhibitory concentrations from 1987 to 2009. Moreover, MIC values of secondary isolates were higher than those of primary isolates. In addition, there is an increasing tendency for the emergence of strains with multi-drug resistance. Resistance rates of H. pylori to amoxicillin, clarithromycin, metronidazole, tetracycline, ciprofloxacin, levofloxacin, and moxifloxacin have been reported up to 18.5%, 38.5%, 66.2%, 34.6%, 34.6%, 29.5%, and 23.2%, respectively. Especially, antibiotic resistance to metronidazole or clarithromycin affects undermining the efficacy of eradication treatment. Further nation-wide surveillance regarding the effect of antibiotic resistance on the eradication rate is necessary to establish the appropriate treatment for H. pylori infection.

Keyword

Helicobacter pylori

MeSH Terms

Adenocarcinoma
Amoxicillin
Anti-Bacterial Agents
Aza Compounds
B-Lymphocytes
Ciprofloxacin
Clarithromycin
Drug Resistance, Microbial
Drug Resistance, Multiple
Gastritis
Helicobacter
Helicobacter pylori
Humans
Lymphoma
Lymphoma, Non-Hodgkin
Metronidazole
Microbial Sensitivity Tests
Ofloxacin
Peptic Ulcer
Point Mutation
Prevalence
Proton Pump Inhibitors
Quinolines
Stomach
Stomach Neoplasms
Tetracycline
Treatment Failure
Amoxicillin
Anti-Bacterial Agents
Aza Compounds
Ciprofloxacin
Clarithromycin
Lymphoma, Non-Hodgkin
Metronidazole
Ofloxacin
Proton Pump Inhibitors
Quinolines
Stomach Neoplasms
Tetracycline