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Primary Antibiotic Resistance of Helicobacter pylori in China

Digestive Diseases and Sciences volume 62, pages 1146–1154 (2017)Cite this article

Abstract

Background and Aims

Antibiotic resistance is the most important factor leading to the failure of eradication regimens; thus, it is important to obtain regional antibiotic resistance information. This review focuses on the prevalence of Helicobacter pylori primary resistance to clarithromycin, metronidazole, amoxicillin, levofloxacin, tetracycline, and furazolidone in China.

Methods

We searched the PubMed, EMBASE, the China National Knowledge Infrastructure, and Chinese Biomedical databases from the earliest date of each database to October 2016. The search terms included the following: H. pylori, antibiotic (including clarithromycin, metronidazole, amoxicillin, levofloxacin, tetracycline, and furazolidone) resistance with or without China or different regions of China. The data analysis was performed using MedCalc 15.2.2. Each article was weighted according to the number of isolated H. pylori strains. A pooled proportion analysis was performed.

Results

Twenty-three studies (14 studies in English and 9 in Chinese) were included in this review. A total of 6274, 6418, 3921, 5468, 2802, and 275 H. pylori strains were included in this review to evaluate the prevalence of H. pylori primary resistance to clarithromycin, metronidazole, levofloxacin, amoxicillin, tetracycline, and furazolidone, respectively. Overall, the primary resistance rates of clarithromycin, metronidazole, levofloxacin, amoxicillin, tetracycline, and furazolidone were 28.9, 63.8, 28.0, 3.1, 3.9, and 1.7%, respectively.

Conclusions

In China, the prevalence of H. pylori primary resistance to clarithromycin, metronidazole, and levofloxacin was high and increased over time, whereas the resistance rates to amoxicillin, tetracycline, and furazolidone were low and stable over time.

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Acknowledgments

We thank Professor David Y. Graham at Baylor College of Medicine for providing advice regarding this review. This work was supported by the National Natural Science Foundation of China (Nos. 81270479, 81460116, 81470832, and 81670507), the Graduate Innovation Fund of Jiangxi Province (YC2016-B025), Grants from the Jiangxi Province Talent 555 Project, and the National Science and Technology Major Projects for “Major New Drugs Innovation and Development” of China (No. 2011ZX09302-007-03).

Author’s contribution

HY wrote the manuscript; ZY and LNH revised the review.

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  1. Department of Gastroenterology, The First Affiliated Hospital of Nanchang University, 17 YongWaizheng Street, Donghu District, Nanchang, 330006, Jiangxi Province, China

    Yi Hu, Yin Zhu & Nong-hua Lu

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  1. Yi Hu
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  2. Yin Zhu
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Correspondence to Yin Zhu or Nong-hua Lu.

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Hu, Y., Zhu, Y. & Lu, Nh. Primary Antibiotic Resistance of Helicobacter pylori in China. Dig Dis Sci 62, 1146–1154 (2017). https://doi.org/10.1007/s10620-017-4536-8

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Keywords

  • Helicobacter pylori
  • Clarithromycin
  • Metronidazole
  • Levofloxacin
  • Resistance
  • China