ArticlePloS one2015
The Primary Resistance of Helicobacter pylori in Taiwan after the National Policy to Restrict Antibiotic Consumption and Its Relation to Virulence Factors-A Nationwide Study.
Article in PloS one, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 42 papers, 3 of them syntheses that pooled it.
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Who cites it
42 citing papers in PubMed, 3 syntheses or guidelines pooled it, 86 citations in OpenAlex.
- Clinical relevance of the cagA and vacA s1m1 status and antibiotic resistance in Helicobacter pylori: a systematic review and meta-analysis.BMC infectious diseases · 2022Pooled it
- Impact of national interventions to promote responsible antibiotic use: a systematic review.The Journal of antimicrobial chemotherapy · 2020Pooled it
- Pooled it
- Ten-Day Quadruple Therapy Comprising Proton Pump Inhibitor, Bismuth, Tetracycline, and Levofloxacin is More Effective than Standard Levofloxacin Triple Therapy in the Second-Line Treatment of Helicobacter pylori Infection: A Randomized Controlled Trial.The American journal of gastroenterology · 2017Trial
- Vonoprazan-Based Regimen Is More Useful than PPI-Based One as a First-LineCanadian journal of gastroenterology & hepatology · 2017Trial
- Trial
- A Pilot Randomized Controlled Study of Dexlansoprazole MR-Based Triple Therapy for Helicobacter Pylori Infection.Medicine · 2016Trial
- Levofloxacin Sequential Therapy vs Levofloxacin Triple Therapy in the Second-Line Treatment of Helicobacter pylori: A Randomized Trial.The American journal of gastroenterology · 2016Trial
- Global Profile of Drug Resistance Related toHealth science reports · 2025Review
- Prevalence and Variability ofAntibiotics (Basel, Switzerland) · 2025Article
- OptimizingGut and liver · 2023Review
- Study on the value of antibiotic-resistant gene detection inExperimental and therapeutic medicine · 2022Article
- Factors Affecting the Intraluminal Therapy forMicroorganisms · 2022Article
- Treatment of RefractoryGut and liver · 2022Review
- Severe duodenal ulcer behaves like gastroduodenal intussusception.Annals of the Royal College of Surgeons of England · 2022Article
- The efficacies of non-bismuth containing quadruple therapies in the treatment of first-line anti-Helicobacter pylori across 4-year time interval with changing antibiotics resistance.Biomedical journal · 2021Article
- The Application of High-Dose Proton Pump Inhibitor Induction Treatment before Dual Therapy forJournal of clinical medicine · 2021Article
- Secular decreasing trends in gastric cancer incidence in Taiwan: A population-based cancer registry study.World journal of gastroenterology · 2021Article
- A High-Throughput Metabolic Microarray Assay Reveals Antibacterial Effects of Black and Red Raspberries and Blackberries againstAntibiotics (Basel, Switzerland) · 2021Article
- Primary and secondary clarithromycin resistance in Helicobacter pylori and mathematical modeling of the role of macrolides.Nature communications · 2021Article
Corrections and comments
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Authors and funding
20 authors at 11 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveThe Taiwan Government issued a policy to restrict antimicrobial usage since 2001. We aimed to assess the changes in the antibiotic consumption and the primary resistance of H. pylori after this policy and the impact of virulence factors on resistance.
methodsThe defined daily dose (DDD) of antibiotics was analyzed using the Taiwan National Health Insurance (NHI) research database. H. pylori strains isolated from treatment naïve (N=1395) and failure from prior eradication therapies (N=360) from 9 hospitals between 2000 and 2012 were used for analysis. The minimum inhibitory concentration was determined by agar dilution test. Genotyping for CagA and VacA was determined by PCR method.
resultsThe DDD per 1000 persons per day of macrolides reduced from 1.12 in 1997 to 0.19 in 2008, whereas that of fluoroquinolones increased from 0.12 in 1997 to 0.35 in 2008. The primary resistance of amoxicillin, clarithromycin, metronidazole, and tetracycline remained as low as 2.2%, 7.9%, 23.7%, and 1.9% respectively. However, the primary levofloxacin resistance rose from 4.9% in 2000-2007 to 8.3% in 2008-2010 and 13.4% in 2011-2012 (p=0.001). The primary resistance of metronidazole was higher in females than males (33.1% vs. 18.8%, p<0.001), which was probably attributed to the higher consumption of nitroimidazole. Neither CagA nor VacA was associated with antibiotic resistance.
conclusionsThe low primary clarithromycin and metronidazole resistance of H. pylori in Taiwan might be attributed to the reduced consumption of macrolides and nitroimidazole after the national policy to restrict antimicrobial usage. Yet, further strategies are needed to restrict the consumption of fluoroquinolones in the face of rising levofloxacin resistance.
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