- Treatment with a macrolide, even years earlier, may predict Helicobacter pylori treatment failure with clarithromycin-containing regimens.
- Prospective studies are needed in multiple geographic regions.
Why this matters
- H pylori resistance to clarithromycin is rising.
- Few data exist on the relationship between prior use of antibiotics and H pylori eradication failure.
- Retrospective cohort study of 212 prospectively recruited Spanish patients with H pylori infection between 2014 and 2016.
- Participants took 1 of 2 clarithromycin-containing eradication regimens: triple or concomitant quadruple therapy.
- Researchers assessed eradication success or failure and checked medical records for prescriptions for macrolides, amoxicillin, metronidazole, or quinolones since 2004.
- Funding: None.
- 47.2% patients had previously been prescribed macrolides (mean, 2.15 treatments).
- Previous macrolide prescription correlated with lower eradication rates:
- On univariate analysis, 73/100 exposed patients (73%) had successful eradication vs 107/112 unexposed patients (95.5%) (P<.0001>
- On multivariate analysis: OR, 0.13 (P<.0001>
- Prescriptions used as proxy for intake.
- Generalizability outside Spain is unclear.