Results of treatment based on clarithromycin resistance for the eradication of Helicobacter pylori
- VernacularTitle:Кларитромицины тэсвэржилтэд үндэслэсэн Helicobacter pylori-ийг устгах бай эмчилгээний үр дүн
- Author:
Tsolmon B
1
,
2
;
Sarantuya G
1
;
Zoljargal G
3
;
Khosbayar T
3
;
Byambajav Ts
1
Author Information
1. Department og Gastroenterology and Hepatolog, School of medicine, MNUMS
2. Intermed hospital
3. Clinical Molecular Diagnostic Center, MNUMS
- Publication Type:Journal Article
- Keywords:
Helicobacter pylori;
Antibiotic therapy;
Clarithromycin resistance;
A2143G mutation
- From:
Mongolian Journal of Health Sciences
2025;86(2):65-69
- CountryMongolia
- Language:Mongolian
-
Abstract:
Background:Helicobacter pylori (H. pylori) is a gram-negative, microaerophilic bacterium that colonizes the human
gastric mucosa, with an estimated global prevalence exceeding 50%. The increasing resistance of H. pylori to
clarithromycin, a key antibiotic in eradication regimens, has led to a decline in the efficacy of standard treatment to below
80%. Consequently, international guidelines advocate for susceptibility-guided therapy to optimize treatment outcomes.
Detection of clarithromycin resistance-associated mutations, including A2143G, A2142G, A2142C, and A2144G, is
essential for improving therapeutic efficacy and mitigating the propagation of antimicrobial resistance.
Aim:To evaluate the efficacy of tailored H. pylori eradication therapy based on clarithromycin resistance profiling.
Materials and Methods:A total of 125 treatment-naïve patients diagnosed with H. pylori infection were enrolled in this
study. The infection was confirmed through upper gastrointestinal endoscopy with histopathological analysis, the urea
breath test, and stool antigen detection. Clarithromycin resistance-associated mutations were identified using polymerase
chain reaction (PCR) analysis on gastric biopsy and stool samples. Based on the presence or absence of resistance
mutations, patients were stratified into two treatment cohorts and received targeted eradication therapy. Treatment success
was assessed 28 days post-therapy using a stool antigen test to confirm H. pylori eradication.
Results:Among the 120 patients who met the inclusion criteria and completed treatment, 41.6% (n=50) were male, and
58.4% (n=70) were female, with a mean age of 39±9.1 years. Clarithromycin resistance-associated mutations were detected
in 36 patients (30%), with A2143G identified in 35 cases (97.2%) and A2142G in 1 case (2.7%).
In the clarithromycin-sensitive cohort, 84 patients underwent eradication therapy, and among the 60 who completed
post-treatment assessment, the eradication rate was 91.6%. In the clarithromycin-resistant cohort, 36 patients received
treatment, and among the 20 who completed post-treatment assessment, the eradication rate was 80% (p=0.038).
Conclusion:A substantial prevalence of clarithromycin resistance-associated mutations was observed among the study
population. Susceptibility-guided eradication therapy demonstrated superior efficacy, with eradication rates exceeding
90%. These findings underscore the necessity of implementing resistance-based treatment strategies to optimize clinical
outcomes and limit the further dissemination of antimicrobial resistance. Future investigations should focus on refining
therapeutic approaches for H. pylori strains exhibiting clarithromycin resistance.
- Full text:20250527140056417465-69.pdf
