Drug Resistance Patterns of Commonly Used Antibiotics for the Treatment of Helicobacter pylori Infection among South Asian Countries: A Systematic Review and Meta-Analysis

Tropical Medicine and Infectious Disease

article

Abhigan Babu Shrestha¹  Pashupati Pokharel²  Unnat Hamal Sapkota¹  Sajina Shrestha³  Shueb A. Mohamed⁴  Surakshya Khanal²  Saroj Kumar Jha²  Aroop Mohanty⁵  Bijaya Kumar Padhi⁶  Ankush Asija⁷  Yub Raj Sedhai⁸  Rishikesh Rijal⁹  Karan Singh⁸  Vijay Kumar Chattu^1,10  Alfonso J. Rodriguez-Morales^1,13  Joshuan J. Barboza^1,16  Ranjit Sah² 

[1] M Abdur Rahim Medical College;Department of Medicine, Maharajgunj Medical Campus, Institute of Medicine, Tribhuvan University;Department of Internal Medicine, KIST Medical College;School of Medicine, Alexandria University;Department of Microbiology, All India Institute of Medical Sciences;Department of Community Medicine and School of Public Health, Postgraduate Institute of Medical Education and Research;School of Medicine, West Virginia University;Division of Pulmonary Disease and Critical Care Medicine, University of Kentucky College of Medicine;Division of infectious Diseases, University of Louisville;Department of Occupational Science and Occupational Therapy, Temerty Faculty of Medicine, University of Toronto;Center for Transdisciplinary Research, Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences, Saveetha University;Department of Community Medicine, Faculty of Medicine, Datta Meghe Institute of Medical Sciences;Grupo de Investigación Biomedicina, Faculty of Medicine, Fundación Universitaria Autónoma de las Américas;Master’s Program in Clinical Epidemiology and Biostatistics, Universidad Cientifica del Sur;Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University;Escuela de Medicina, Universidad Cesar Vallejo;Department of Microbiology, Dr. D. Y. Patil Medical College, Hospital and Research Centre;Department of Public Health Dentistry, Dr. D.Y. Patil Dental College and Hospital

关键词: antibiotic resistance;    Helicobacter pylori;    South Asia;    meta-analysis;    metronidazole;    clarithromycin;    tetracycline;    fluroquinolones;    amoxicillin;   

DOI  :  10.3390/tropicalmed8030172

学科分类：社会科学、人文和艺术（综合）

来源: mdpi

【 摘 要 】

Background: In South Asia, resistance to commonly used antibiotics for the treatment of Helicobacter pylori infection is increasing. Despite this, accurate estimates of overall antibiotic resistance are missing. Thus, this review aims to analyze the resistance rates of commonly used antibiotics for the treatment of H. pylori in South Asia. Methods: The systematic review and meta-analysis was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis statement. We searched five medical databases for relevant studies from inception to September 2022. A random effect model with a 95% confidence interval (CI) was used to calculate the pooled prevalence of antibiotic resistance. Results: This systematic review and meta-analysis included 23 articles, 6357 patients, 3294 Helicobacter pylori isolates, and 2192 samples for antibiotic resistance. The prevalences of antibiotic resistance to common antibiotics were clarithromycin: 27% (95%CI: 0.17–0.38), metronidazole: 69% (95%CI: 0.62–0.76), tetracycline: 16% (95%CI: 0.06–0.25), amoxicillin: 23% (95%CI: 0.15–0.30), ciprofloxacin: 12% (95%CI: 0.04–0.23), levofloxacin: 34% (95%CI: 0.22–0.47), and furazolidone: 14% (95%CI: 0.06–0.22). Subgroup analysis showed antibiotic resistances were more prevalent in Pakistan, India, and Bangladesh. Furthermore, a ten-year trend analysis showed the increasing resistance prevalence for clarithromycin (21% to 30%), ciprofloxacin (3% to 16%), and tetracycline (5% to 20%) from 2003 to 2022. Conclusion: This meta-analysis showed a high prevalence of resistance among the commonly used antibiotics for H. pylori in South Asian countries. Furthermore, antibiotic resistance has been increasing over the time of 20 years. In order to tackle this situation, a robust surveillance system, and strict adherence to antibiotic stewardship are required.

【 授权许可】

CC BY