Management of Antibiotic-Resistant Helicobacter pylori Infection: Perspectives from Vietnam

Gut Liver. 2019 Sep 15;13(5):483-497. doi: 10.5009/gnl18137.

Abstract

Antibiotic resistance is the most important factor leading to the failure of eradication regimens. This review focuses on the prevalence of Helicobacter pylori primary and secondary resistance to clarithromycin, metronidazole, amoxicillin, levofloxacin, tetracycline, and multidrug in Vietnam. We searched the PubMed, EMBASE, Vietnamese National Knowledge Infrastructure, and Vietnamese Biomedical databases from January 2000 to December 2016. The search terms included the following: H. pylori infection, antibiotic (including clarithromycin, metronidazole, amoxicillin, levofloxacin, tetracycline, and multidrug) resistance in Vietnam. The data were summarized in an extraction table and analyzed manually. Finally, Excel 2007 software was used to create charts. Ten studies (three studies in English and seven in Vietnamese) were included in this review. A total of 308, 412, 523, 408, 399, and 268 H. pylori strains were included in this review to evaluate the prevalence of H. pylori primary resistance to amoxicillin, clarithromycin, metronidazole, levofloxacin, tetracycline, and multidrug resistance, respectively. Overall, the primary resistance rates of amoxicillin, clarithromycin, metronidazole, levofloxacin, tetracycline, and multidrug resistance were 15.0%, 34.1%, 69.4%, 27.9%, 17.9% and 48.8%, respectively. Secondary resistance rates of amoxicillin, clarithromycin, metronidazole, levofloxacin, tetracycline, and multidrug resistance were 9.5%, 74.9%, 61.5%, 45.7%, 23.5% and 62.3%, respectively. In Vietnam, primary and secondary resistance to H. pylori is increasing over time and affects the effectiveness of H. pylori eradication.

Keywords: Amoxicillin; Bismuth; Clarithromycin; Helicobacter pylori; Metronidazole.

Publication types

  • Review

MeSH terms

  • Anti-Bacterial Agents / therapeutic use
  • Chronic Disease
  • Disease Eradication / methods
  • Disease Eradication / trends
  • Drug Resistance, Multiple, Bacterial / drug effects*
  • Drug Resistance, Multiple, Bacterial / genetics
  • Drug Therapy, Combination
  • Gastritis / complications
  • Gastritis / epidemiology
  • Genes, Bacterial / genetics
  • Helicobacter Infections / drug therapy*
  • Helicobacter Infections / epidemiology
  • Helicobacter Infections / prevention & control
  • Helicobacter pylori / drug effects*
  • Helicobacter pylori / genetics
  • Humans
  • Mutation / genetics
  • Peptic Ulcer / complications
  • Peptic Ulcer / epidemiology
  • Prevalence
  • Proton Pump Inhibitors / therapeutic use
  • Risk Factors
  • Stomach Neoplasms / complications
  • Stomach Neoplasms / epidemiology
  • Vietnam / epidemiology

Substances

  • Anti-Bacterial Agents
  • Proton Pump Inhibitors