Antimicrobial susceptibility of 6 antimicrobial agents in Helicobacter pylori clinical isolates by using EUCAST breakpoints compared with previously used breakpoints

High primary antibiotic resistance of Helicobacter Pylori strains isolated from dyspeptic patients: A prevalence cross‐sectional study in Spain

“…The high rate of clarithromycin resistance observed in this study (22.4%) is in line with most recent publications: 14.7%, 17.9%, 21.5%, 17.6% in other areas of Spain; 22.2% in France; 17.5% in Europe, or 23.7% in Korea . Even higher rates of clarithromycin resistance have been reported in Spain (51.2%), Japan (38.8%), and China (52.6%) . Anecdotally, a significantly lower resistance rate was reported in Ireland (9.3%) .…”

“…Metronidazole has been widely used to treat infections such as parasitic or female genital infections and that fact could contribute to the high resistance rate found in different geographic areas. However, in this study, resistance to metronidazole (27%) was slightly lower than previously reported: 45.1% and 39.2% in Spain, 34.9% in whole Europe, 45.9% in France, 29.1% in Ireland, or 63.4% in China. Although metronidazole resistance is known to have a limited clinical impact on H. pylori treatment, increasing the dosage and/or dosing frequency of this antibiotic, or the use of metronidazole as part of bismuth‐containing quadruple therapy may be indicated to avoid any negative impact of metronidazole resistance on H. pylori eradication …”

“…It should be noted that resistance observed to levofloxacin (38.7%), a quinolone that has been increasingly used for second‐line eradication therapy, was significantly higher than expected in Spain and Europe. The previously mentioned European multicenter study reported a rate of levofloxacin resistance of 14.1%, while similar rates were recently described in France (15.4%) and Spain (14.5%, 13.9%, and 6.7%). Higher primary resistance rates to levofloxacin have been described in Asia (up to 28.1% in Korea, 34% in Japan, and 54.8% in China).…”

“…Results concerning primary resistance to tetracycline (0%) were as expected, confirming that the use of this antibiotic in bismuth‐containing quadruple therapies is a good option as initial treatment of H. pylori in Spain. Similar rates of tetracycline resistance have been reported in Europe (0.9%), Spain (0% and 0.6%), and France (0%) …”

“…In addition, it has been previously suggested that resistance to amoxicillin does not reduce the efficacy of treatment . Amoxicillin resistance has been reported to be as high as 8.5% in Spain or 4.4% in China, and as low as 1.4% in Spain, 0.7% in France, or 0.7% in whole Europe . Six strains appeared initially to be resistant to amoxicillin in the current series.…”