先前使用抗生素对幽门螺杆菌克拉霉素耐药性的影响。

Effects of prior antibiotic use on clarithromycin resistance in Helicobacter pylori.

机构信息

Department of Orthopaedic Surgery, Hallym University Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, South Korea.

Department of Internal Medicine, Hallym University Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, South Korea.

出版信息

Helicobacter. 2023 Jun;28(3):e12974. doi: 10.1111/hel.12974. Epub 2023 Mar 28.

DOI:10.1111/hel.12974

PMID:36975018

Abstract

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.

摘要

背景

大环内酯类抗生素被广泛用于治疗肺炎和鼻窦炎等各种感染，先前接触大环内酯类抗生素被认为是幽门螺杆菌（H. pylori）标准三联疗法失败的危险因素。我们旨在确定先前使用大环内酯类抗生素是否会影响 H. pylori 对克拉霉素的耐药性。

材料和方法

从韩国国家健康保险服务（NHIS2021-1-775）数据库中，确定了 2016 年至 2019 年期间在韩国接受 H. pylori 克拉霉素耐药性检测的 46160 名患者。调查了他们过去 10 年的抗生素使用史和过去 1 年的呼吸道合并症史。

结果

韩国 H. pylori 克拉霉素耐药率为 16.2%。多变量分析显示，女性（OR：1.472，p<0.001）、年龄>50 岁（OR：1.340，p<0.001）、先前使用大环内酯类抗生素（克拉霉素，OR：2.902，p<0.001；阿奇霉素，OR：1.930，p<0.001；红霉素，OR：2.060，p=0.001；罗红霉素，OR：2.022，p<0.001）和呼吸道合并症史（鼻窦炎，OR：1.271，p<0.001；喉咽炎，OR：1.135，p=0.032；支气管炎，OR：1.245，p=0.001；肺炎，OR：1.335，p=0.026）是 H. pylori 对克拉霉素耐药的独立危险因素。