Clarithromycin resistance has doubled in two decades

Clarithromycin resistance has doubled in two decades
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Clarithromycin resistance – a commonly-used antibiotic for treating harmful bacteria related to a variety of stomach conditions – has more than doubled in 20 years.

A new study analysed 1,232 patients from across 18 European countries – investigating resistance to antibiotics regularly taken for Helicobacter pylori (H. pylori) infection, a harmful bacterium associated with gastric ulcer, lymphoma and gastric cancer.

Resistance to clarithromycin, one of the most established antimicrobials used to eradicate H. pylori, had increased from 9.9% in 1998 to 21.6% last year, with increases in resistance also seen for levofloxacin and metronidazole.

The new research was presented at UEG Week Barcelona 2019.

Global health crisis

Microbial resistance to antibiotics is one of the biggest threats to global health today. As more people have been prescribed antibiotics to deal with different health problems – the more bacteria have adapted and are able to survive exposure to medications designed to kill or halt their growth. This has led to a global health crisis – causing more than 75,000 deaths worldwide every year.

Lead researcher Professor Francis Megraud, said: “H. pylori infection is already a complex condition to treat, requiring a combination of medications. With resistance rates to commonly used antibiotics such as clarithromycin increasing at an alarming rate of nearly 1% per year, treatment options for H. pylori will become progressively limited and ineffective if novel treatment strategies remain undeveloped.

“The reduced efficacy of current therapies could maintain the high incidence rates of gastric cancer and other conditions such as peptic ulcer disease, if drug resistance continues to increase at this pace.”

Clarithromycin resistance

H. pyloriis one of the most common bacterial infections in humans and is estimated to be present in one-half of the world’s population. When this bacterium contaminates your stomach, it can lead to inflammation of the stomach lining, namely gastritis, which can result in peptic ulcers. H. pyloriis also the most important risk factor for gastric cancer, the seventh leading cause of cancer death in Europe and the third worldwide.

In recent years, H. pylori antibiotic resistance has become a prominent and urgent issue across the globe. Underlining the severity of the situation, in 2017, the World Health Organisation identified H. pylori clarithromycin resistant as a high priority bacterium for antibiotic research and development.

It found that the rates of primary clarithromycin resistance in H. pylori were highest in Southern Italy (39.9%), Croatia (34.6) and Greece (30%), aligning with previous reports that predict that both Italy and Greece will have the highest number of deaths due to antimicrobial resistance amongst EU members by 2050.

Endangering prevention strategies

These high levels of clarithromycin resistance in these countries has been attributed to the overconsumption of antibiotics for common illnesses such as cold and flu, as well as a lack of institutional support for antibiotic resistance containment strategies.

Mário Dinis-Ribeiro, President of the European Society of Gastrointestinal Endoscopy, said: “The findings of this study are certainly concerning, as H. pylori is the main cause of peptic disease and gastric cancer.

“The increasing resistance of H. pylori to a number of commonly-used antibiotics may jeopardise prevention strategies.”

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