Antibiotic Resistance of Helicobacter Pylori in Primary Care: An Observational Cohort Study

Introduction Helicobacter pylori (H. pylori) is causally associated with chronic gastritis, peptic ulcer and gastric cancer, a reported prevalence of 19-35%. Due to increasing antibiotic resistance, the worldwide efficacy H. eradication treatment has decreased. Aims & Methods This study aimed determine success in primary care Netherlands, as proxy measure for resistance development. Real-world routine health data from Electronic Medical Records general practices region Leiden/The Hague was used. Data provided by ELAN (Extramural LUMC Academic Network). Patients an ICPC-code symptoms or ATC code acid inhibition period 2010-2020 were selected. Pylori infection detected based on having received treatment. We investigated defined prescription second within 12 months. The types antibiotics prescribed first evaluated rates. If no months, patients considered have been successfully treated. Results identified 138,455 80 practices. Mean age 57 years (SD 18.2) whom 43% male. A total 5,224 (4%) positive. combinations amoxicillin-clarithromycin, amoxicillin-metronidazole clarithromycin-metronidazole used 4,847 (93%), 154 (3%) 111 (2%) treatments, respectively. one year 416 (8%) patients. Thereof, 380 16 (10%) 11 resistant. saw 0.8% increment per need (p=0.003, 95% CI 0.33-1.22). Conclusion Almost one-tenth infections are not treated using intervention clarithromycin and/or metronidazole require Our leads conclusion that plays slowly role pylori. Further targeting guidelines