Abstract
Background and Aim Helicobacter pylori is a class I carcinogen. Nowadays, the problem of antibiotic resistance is increasing worldwide. The latest prevalence rates of infection and resistant status in Thailand vary or are out of date. Our aims are to identify the current prevalence and antibiotic resistance patterns in Thailand and to suggest regimens for treatment‐naive and ‐resistant patients.MethodsThis descriptive retrospective study was conducted, using a urea breath test, on patients in King Chulalongkorn Memorial Hospital between 2013 and 2017. They were categorized into the diagnostic group and posttreatment group. Specimens from some patients were cultured to identify the antibiotic‐resistant pattern.ResultsThere were 1894 patients included in our study. The prevalence of H. pylori infection in dyspeptic patients was 28.4%. Of 1258 patients, 1165 (92.61%) responded to initial treatment. The 95 patients who failed to respond could respond to second‐line treatment of longer period, at higher doses, or using other antibiotics (success rate 68.42%). There were 21.43, 14.29, and 10.71% of patients resistant to ciprofloxacin, metronidazole, and clarithromycin, respectively. However, no patients resistant to amoxicillin, tetracycline, and levofloxacin were found.ConclusionThe prevalence of H. pylori infection in Thailand has increased slightly. Initial regimens (triple therapy or sequential therapy or quadruple therapy) can be effective for the eradication of H. pylori infection, with a success rate of > 90%. For patients who failed to respond to initial triple therapy, using a longer duration of triple therapy or changing to quadruple therapy could be a good alternative. The resistance rates of amoxicillin, metronidazole, levofloxacin, and tetracycline are declining, but those of clarithromycin and ciprofloxacin are increasing.
Highlights
Helicobacter pylori (H. pylori) is a helix-shaped, Gram-negative, microaerophilic bacterium. It has clinical significance as it is the root of many diseases such as gastric inflammation; atrophic gastritis; nonulcer dyspepsia; and peptic ulcer,[1] which is the most common disease caused by H. pylori infection
H. pylori is a pathogen known as a definite carcinogen,[2] and chronic infection because of this pathogen is found to be associated with gastric mucosa-associated lymphoid tissue (MALT) lymphoma, colorectal adenomas, pancreatic cancer, and throat cancer.[1,3]
The prevalence of H. pylori infection diagnosed from the urea breath test (UBT) is 28.4%
Summary
Helicobacter pylori (H. pylori) is a helix-shaped, Gram-negative, microaerophilic bacterium It has clinical significance as it is the root of many diseases such as gastric inflammation; atrophic gastritis; nonulcer dyspepsia; and peptic ulcer,[1] which is the most common disease caused by H. pylori infection. The latest prevalence rates of infection and resistant status in Thailand vary or are out of date. Methods: This descriptive retrospective study was conducted, using a urea breath test, on patients in King Chulalongkorn Memorial Hospital between 2013 and 2017. Conclusion: The prevalence of H. pylori infection in Thailand has increased slightly. Initial regimens (triple therapy or sequential therapy or quadruple therapy) can be effective for the eradication of H. pylori infection, with a success rate of > 90%. The resistance rates of amoxicillin, metronidazole, levofloxacin, and tetracycline are declining, but those of clarithromycin and ciprofloxacin are increasing
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