Metronidazole-resistant Helicobacter pylori in an urban Asian population

Background: Helicobacter pylori eradication is the mainstay in the treatmen t of H. pylori-associated peptic ulcer disease. Metronidazole is an importa nt component in most eradication regimens. However, the presence of metroni dazole-resistant H. pylori adversely affects the efficacy of such regimens. We aimed to study the prevalence of metronidazole resistance in our popula tion, and the factors associated with its presence. Methods and Results: From September 1993 to September 1996, 459 H. pylori i solates were collected and analysed. The overall resistance rate was 62.7%. The rate was significantly higher among women compared with men (P < 0.05) . When the results were analysed according to each year, there was a signif icant increase in the resistance rate from 50.5% in the first year to 72.7% in the third year (P = 0.0039). Conclusions: There was a significant rise in the prevalence of metronidazol e resistance over a 3-year period. The presence of metronidazole resistance adversely affects the eradication rates of nitroimidazole-based regimens. Hence, in a population with a high prevalence of metronidazole resistance, the use of non-nitroimidazole-based therapy may be more efficacious. This i nformation on resistance rates is important for the empirical choice of ant ibiotic against H. pylori in a population. (C) 2000 Blackwell Science Asia Pty Ltd.