Antibiotic Resistance in <i>Helicobacter pylori</i> Infection

Kim, Jae G; Kim, Beom Jin

doi:2011.11.1.13

Korean J Helicobacter Up Gastrointest Res > Volume 11(1); 2011 > Article

Review

The Korean Journal of Helicobacter and Upper Gastrointestinal Research 2011;11(1):13-20.
DOI: https://doi.org/10.7704/kjhugr.2011.11.1.13 Published online June 10, 2011.

Antibiotic Resistance in Helicobacter pylori Infection

Jae G Kim, Beom Jin Kim

Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Korea. jgkimd@cau.ac.kr

헬리코박터의 항생제 내성

김재규, 김범진

중앙대학교 의과대학 내과학교실

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.

Key Words: Helicobacter pylori