Susceptibility of H elicobacter pylori to antibiotics in C hinese patients

Objective Antibiotic resistance to H elicobacter pylori ( H . pylori ) has been increasing worldwide. The study aimed to evaluate in vitro susceptibility and resistance patterns to antibiotics in empirical H . pylori eradication regimens, and to determine the optimal antibiotics for treatment. Methods H . pylori strains ( n =181) were obtained from gastric biopsies of patients with upper gastrointestinal symptoms who underwent esophagogastroduodenoscopy from M arch to D ecember 2013. The susceptibility of H . pylori strains to amoxicillin ( AMX ), metronidazole ( MTZ ), clarithromycin ( CLR ), amoxicillin‐clavulanate ( AMC ), cephalothin ( CEP ), cefuroxime ( CXM ), cefixime ( CFM ), moxifloxacin ( MFX ) and minocycline ( MNO ) was determined. Results Dual resistance to MTZ  +  CLR was detected in 48 (26.5%) isolates, MTZ  +  MFX in 94 (51.9%), and CLR  +  MFX in 49 (27.1%). Overall, 41 (22.7%) were resistant to MTZ  +  CLR  +  MFX . MTZ and CLR resistance rates were significantly associated with the history of H. pylori eradication but there was no significant difference in MFX resistance rates between treated and untreated patients ( P  = 0.674). No significant relationship was found between antibiotic resistance and patient's gender, age, endoscopic findings, inflammatory severity or gastric atrophy. Conclusions AMX , AMC , MNO and cephalosporins, but not MTZ , CLR and MFX , showed good in vitro anti‐ H . pylori activity. Among cephalosporins, CXM was the most active. H . pylori resistance is higher in patients with previous H. pylori eradication.