Background: Macrolide antibiotics are widely used to treat various infections such as pneumonia and sinusitis, and previous exposure to macrolides is presumed to be a risk factor for standard triple therapy failure in Helicobacter pylori (H. pylori) eradication. We aimed to determine whether previous use of macrolide antibiotics could affect clarithromycin resistance of H. pylori.
Materials and methods: From the Korea National Health Insurance Service (NHIS2021-1-775) database, a total of 46,160 patients who were tested for clarithromycin resistance of H. pylori from 2016 to 2019 in Korea were identified. Their history of antibiotics in the past 10 years and history of respiratory comorbidity in the past 1 year were investigated.
Results: Clarithromycin resistance rate of H. pylori in Korea was 16.2%. A multivariate analysis revealed that female sex (OR: 1.472, p < .001), age > 50 years (OR: 1.340, p < .001), previous use of macrolide antibiotics (clarithromycin, OR: 2.902, p < .001; azithromycin, OR: 1.930, p < .001; erythromycin, OR: 2.060, p = .001; roxithromycin, OR: 2.022, p < .001), and history of respiratory comorbidity (sinusitis, OR: 1.271, p < .001; laryngopharyngitis, OR: 1.135, p = .032; bronchitis, OR: 1.245, p = .001; pneumonia, OR: 1.335, p = .026) were independent risk factors of clarithromycin resistance in H. pylori.
Conclusions: The use of macrolide antibiotics and a recent diagnosis of respiratory disease might increase clarithromycin resistance of H. pylori.
Keywords: Helicobacter pylori; antibiotics; drug resistance.
© 2023 John Wiley & Sons Ltd.