Clarithromycin-Based Standard Triple Therapy Can Still Be Effective for Helicobacter pylori Eradication in Some Parts of the Korea.
10.3346/jkms.2014.29.9.1240
- Author:
Kyu Hyun YOON
1
;
Sung Woon PARK
;
Sang Wook LEE
;
Beom Jin KIM
;
Jae Gyu KIM
Author Information
1. Division of Gastroenterology, Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Korea. jgkimd@cau.ac.kr
- Publication Type:Original Article
- Keywords:
Helicobacter pylori;
Clarithromycin Resistance;
Minimum Inhibitory Concentration
- MeSH:
Adult;
Aged;
Anti-Bacterial Agents/pharmacology/*therapeutic use;
Asian Continental Ancestry Group;
Clarithromycin/*therapeutic use;
DNA, Bacterial/analysis;
Drug Resistance, Bacterial/genetics;
Female;
Helicobacter Infections/*drug therapy/microbiology;
Helicobacter pylori/drug effects/genetics/*isolation & purification;
Humans;
Male;
Microbial Sensitivity Tests;
Middle Aged;
Mutation;
Polymerase Chain Reaction;
RNA, Ribosomal, 23S/genetics;
Republic of Korea;
Retrospective Studies;
Sequence Analysis, DNA
- From:Journal of Korean Medical Science
2014;29(9):1240-1246
- CountryRepublic of Korea
- Language:English
-
Abstract:
We evaluated the antibiotic resistance rates and eradication rates of clarithromycin based triple therapy from 2005 to 2010 retrospectively. In addition, we investigated the mechanism of clarithromycin resistance in Helicobacter pylori strains isolated from Korean patients. Two hundred and twelve strains of H. pylori were isolated from 204 patients. H. pylori ATCC 43504 was used as the standard strain. The eradication rates of H. pylori from 2005 to 2010 were 89.3%, 82.6%, 86.3%, 87.7%, 81.8%, and 84.2%, respectively. Total eradication rate was 84.9%. DNA sequences of the 23S RNA gene in clarithromycin-resistant strains were determined. The resistance rates of H. pylori to amoxicillin, clarithromycin, metronidazole, tetracycline, ciprofloxacin, moxifloxacin, and levofloxacin were 9.0%, 8.5%, 36.3%, 0%, 14.2%, 14.2%, and 14.2%, respectively. The multidrug resistance rate of H. pylori was 16.5%. Sequence analysis of clarithromycin-resistant strains showed an A2144G mutation in 8 of 14 strains (57.1%), a T2183C mutation in 5 of 14 strains (35.7%), and double mutations of both A2144G and T2183C in 1 of 14 strains (7.1%). In the present study, triple therapy may still be an effective eradication therapy for H. pylori infections in Korea. The A2144G and T2183C mutations are mainly present in clarithromycin-resistant isolates.
