Antibioticaresistentie van Helicobacter pylori

Objective

To determine the current prevalence of antimicrobial resistance of Helicobacter pylori in the Netherlands, and to draw up empirically based treatment advice.

Design

Cross-sectional retrospective study.

Method

Data were collected from all H. pylori-positive isolates cultured in the Bernhoven Hospital in the southern Netherlands, between 2005 and 2012 in which susceptibility for clarithromycin and metronidazole had been determined. Susceptibility for clarithromycin and metronidazole was determined using the E-test, with cut-off minimum inhibitory concentrations of 0.5 μg/ml and 8 μg/ml, respectively.

Results

Susceptibility to metronidazole was determined in 417 isolates; 10.1% of these were resistant Susceptibility to clarithromycin was determined in 421 isolates; 6.2% of these were resistant. Women carried resistant strains more often than men, but the difference was statistically non-significant. Resistance of H. pylori to clarithromycin has increased in recent years, whereas the resistance to metronidazole has decreased slightly.

Conclusion

The prevalence of resistance of H. pylori to clarithromycin and metronidazole in this region of the Netherlands is still low enough to advise standard therapy consisting of a proton pump inhibitor, amoxicillin and clarithromycin as the empirical therapy of choice. However, resistance to clarithromycin is increasing, so it is important to continue to monitor the prevalence of resistance of H. pylori in the Netherlands.

Conflict of interest and financial support: none declared.