Changing profile of Helicobacter pylori primary antibiotic resistance in Singapore over two decades

Abstract

Objectives: Antibiotic resistance is a key reason for Helicobacter pylori (H. pylori) treatment failure and updated local data are important to guide the choice of empiric first-line therapy. Clarithromycin-based triple therapy (TT) is currently the first-line treatment in Singapore. Our primary aim was to determine the change in pattern of primary antibiotic resistance of H. pylori in Singapore as well as TT success rate.Methods: A registry of H. pylori isolates was tested for primary antibiotic resistance and were analyzed from year 2001 to 2020. Treatment outcome data based on 13 C-urea breath test ( 13 C-UBT) results of empiric first-line 2-week TT from 2019 to 2020 were also analyzed retrospectively.Results: A total of 387 H. pylori isolates were included. Rates of resistance to clarithromycin as well as tetracycline showed a downtrend in the last 5 years (clarithro-