Helicobacter pylori resistance to antibiotics in Europe in 2018 and its relationship to antibiotic consumption in the community

Megraud F, Bruyndonckx R, Coenen S, Wittkop L, Huang TD, Hoebeke M, Bénéjat L, Lehours P, Goossens H, Glupczynski Y, Makristathis A, Boyanova L, Tonkic A, Tonkic M, Andersen L, Blumel B, Glocker E, Tammer I, Link A, Suerbaum S, Dichtl K, Mentis A, Martinez-Gonzales B, Smith S, McNamara D, Pina Dore M, Monno R, Lippolis A, Rudzite D, Leja M, Kupcinskas J, Melby KK, Gosciniak G, Karpinski TM, Oleastro M, Jeverica S, Calvet X, Ramirez-Lázaro MJ, Montes Ros M, Morilla A, Boonstra S, Schneeberger PM (2021)

Publication Type: Journal article

Publication year: 2021

Journal

Book Volume: 70

Pages Range: 1815-1822

Journal Issue: 10

DOI: 10.1136/gutjnl-2021-324032

Abstract

Objective Our aim was to prospectively assess the antibiotic resistance rates in Helicobacter pylori strains in Europe in 2018 and to study the link between antibiotic consumption in the community and H. pylori resistance levels in the different countries. Design The proportion of primary antibiotic resistance cases of H. pylori and their corresponding risk factors were investigated in 24 centres from 18 European countries according to a standardised protocol. Data on antibiotic consumption in the community were collected for the period 2008-2017. The link between antibiotic consumption and resistance data was assessed using generalised linear mixed models. The model with the best fit was selected by means of the Akaike Information Criterion. Results H. pylori resistance rates for the 1211 adult patients included were 21.4% for clarithromycin, 15.8% for levofloxacin and 38.9% for metronidazole and were significantly higher in Central/Western and Southern than in the Northern European countries. The best model fit was obtained for the Poisson distribution using 2013 consumption data. A signi?cant association was found between H. pylori clarithromycin resistance and consumption in the community of macrolides (p=0.0003) and intermediate-acting macrolides (p=0.005), and between levo?oxacin resistance and consumption of quinolones (p=0.0002) and second-generation quinolones (p=0.0003). Conclusion This study confirms the positive correlation between macrolide and quinolone consumption in the community and corresponding H. pylori resistance in European countries. Hence, H. pylori treatment with clarithromycin and levofloxacin should not be started without susceptibility testing in most European countries.

Involved external institutions

National Institute of Health Dr. Ricardo Jorge (INSA) / Instituto Nacional de Saúde Dr. Ricardo Jorge Portugal (PT) Trinity College Dublin Ireland (IE) Università degli Studi di Sassari (UNISS) Italy (IT) Poznan University of Medical Sciences / Uniwersytet Medyczny im. Karola Marcinkowskiego w Poznaniu Poland (PL) Autonomous University of Barcelona (UAB) / Universitat Autònoma de Barcelona Spain (ES) Université de Bordeaux France (FR) Lithuanian University of Health Sciences / Lietuvos sveikatos mokslų universitetas (LSMU) Lithuania (LT) University of Antwerp / Universiteit Antwerpen Belgium (BE) Universitätsklinikum Freiburg Germany (DE) Copenhagen University Hospital Denmark (DK) University of Bari Aldo Moro / Università degli Studi di Bari Aldo Moro Italy (IT) CHU UCL Namur (Dinant, Godinne, Sainte-Elisabeth) Belgium (BE) Central University Hospital of Asturias Spain (ES) Donostia University Hospital / Donostia Unibertsitate Ospitalea Spain (ES) University of Oslo Norway (NO) Wrocław Medical University / Uniwersytet Medyczny we Wrocławiu Poland (PL) Hellenic Pasteur Institute (HPI) Greece (GR) Medizinische Universität Wien Austria (AT) University Hospital Split Croatia (HR) Ludwig-Maximilians-Universität (LMU) Germany (DE) Medical University Sofia / Медицински университет Bulgaria (BG) University of Latvia Latvia (LV) Jeroen Bosch Hospital Netherlands (NL) Otto-von-Guericke-Universität Magdeburg Germany (DE) Centre Hospitalier Universitaire de Bordeaux / CHU Bordeaux France (FR)

How to cite

APA:

Megraud, F., Bruyndonckx, R., Coenen, S., Wittkop, L., Huang, T.D., Hoebeke, M.,... Schneeberger, P.M. (2021). Helicobacter pylori resistance to antibiotics in Europe in 2018 and its relationship to antibiotic consumption in the community. Gut, 70(10), 1815-1822. https://doi.org/10.1136/gutjnl-2021-324032

MLA:

Megraud, Francis, et al. "Helicobacter pylori resistance to antibiotics in Europe in 2018 and its relationship to antibiotic consumption in the community." Gut 70.10 (2021): 1815-1822.

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