Influence of resistance of Helicobacter pylori to antibiotics on the Helicobacter pylori eradication regimens

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To investigate the influence of resistance of Helicobacter pylori (H. pylori) to antibiotics on the efficacy of lansoprazole triple therapy for H. pylori eradication. 157 patients, 102 males and 55 females, aged 42.7 (18 - 70), with upper abdominal symptoms, 59 with chronic gastritis and 98 with peptic ulcer, underwent gastroendoscopy 157 H. pylori strains were isolated from the gastric biopsy specimens of these patients and cultured. Minimal inhibitory concentrations of 3 antibiotics (metronidazole and clarithromycin) were determined by E-test. The 157 patients were treated by triple therapies, including lansoprazole, metronidazole, and clarithromycin for 7 days. Reexamination was done at least 4 weeks after the therapy. The resistance rates of H. pylori to metronidazole and clarithromycin were 45.9% (72/157) and 18.5% (29/157) respectively. The reexamination showed an eradication rate of H. pylori of 61.8% (97/157). The eradication rates of the metronidazole-sensitive and resistant strains were 89.4% (76/85) and 29.2% (21/72) respectively (P < 0.01), and the eradication rates of the clarithromycin-sensitive and resistant strains were 72.7% (93/128) and 16.0% (4/29) respectively (P < 0.01). Presence of a gastroduodenal ulcer, age and gender did not differ significantly between the eradicated and non-eradicated groups (all P > 0.05). Resistance of H. pylori to antibiotics is the most important cause of the failure of H. pylori eradication.