Success of susceptibility-guided eradication of Helicobacter pylori in a region with high secondary clarithromycin and levofloxacin resistance rates

Table 1 The baseline information of Helicobacter pylori isolates (n = 132)

Factors	n	%
Sex (female)	71	53.8
Age (yr, ≥ 50)	85	64.4
BMI (kg/m2, ≥ 25)	61	46.2
Current smoking	23	17.4
Current drinking	26	19.7
Hypertension (yes)	22	16.7
Diabetes (yes)	15	11.4
Gastrointestinal symptoms (yes)	83	62.9
Family members with Helicobacter pylori infection (yes)	41	31.1
Family histories of gastric cancer (yes)	16	12.1
Residence region (urban)	103	78.0

BMI: Body mass index.

Table 2 Antibiotic resistance patterns of Helicobacter pylori strains (n = 132)

Type of resistance	Overall (n = 132)
	Number of strains	Resistance rate (%)
No resistance	13	9.9
Monoresistance	37	28.0
LFX	10	7.6
CLA	27	20.5
Double resistance	82	62.1
CLA + LFX	82	62.1

LFX: Levofloxacin; CLA: Clarithromycin.

Table 3 Rates of antimicrobial resistance stratified by patient characteristics

Characteristics	Clarithromycin		P value	Levofloxacin		P value
	Resistant	Sensitive		Resistant	Sensitive
Age (yr)
≥ 50	20	11	0.068	64	21	0.060
< 50	35	74		28	19
Gender
Male	48	13	0.275	43	18	0.854
Female	61	10		49	22
Current smoking
Yes	20	3	0.076	15	8	0.607
No	89	20		77	32
Current drinking
Yes	24	2	0.246	17	9	0.593
No	85	21		75	31
BMI (kg/m2)
≥ 24	51	10	0.772	45	16	0.345
< 24	58	13		47	24
Hypertension
Yes	20	2	0.363	18	4	0.175
No	89	21		74	36
Diabetes melllitus
Yes	11	4	0.297	10	5	0.772
No	98	19		82	35
Symptoms
Yes	73	10	0.034	61	22	0.217
No	36	13		31	18
Family members with Helicobacter pylori infection
Yes	34	7	0.943	27	14	0.519
No	75	16		65	26
Family histories of gastric cancer
Yes	15	1	0.303	10	6	0.565
No	94	22		82	34
Residence region
Urban	83	20	0.255	66	37	0.008
Rural	26	3		26	3

BMI: Body mass index.

Table 4 Correlations between Helicobacter pylori antibiotic resistance and characteristics of subjects

Variables	Clarithromycin		Levofloxacin
	OR (95%CI)	P value	OR (95%CI)	P value
Age (yr)
< 50	1		1
≥ 50	2.379 (0.924-6.125)	0.072	1.972 (0.888-4.379)	0.095
Current smoking
No	1		1
Yes	1.151 (0.293-4.517)	0.841	0.546 (0.192-1.557)	0.258
Symptoms
No	1		1
Yes	2.782 (1.076-7.194)	0.035	1.851 (0.823-4.166)	0.137
Residence region
Urban	1		1
Rural	1.852 (0.489-7.010)	0.364	5.152 (1.407-18.861)	0.013

OR: Odds ratio; 95%CI: 95% confidence interval.

Table 5 Characteristics of the susceptibility-guided and empiric treatment groups

Characteristics	All (n, %)	Susceptibility-guided treatment (n, %)	Empiric treatment (n, %)	P value
Age (yr)				0.448
< 50	57 (33.7)	31 (54.4)	26 (45.6)
≥ 50	112 (66.3)	54 (48.2)	58 (51.8)
Gender				0.812
Male	78 (46.2)	40 (51.3)	38 (48.7)
Female	91 (53.8)	45 (49.5)	46 (50.5)

Table 6 Eradication rates of the susceptibility-guided and empiric treatment groups

	Susceptibility-guided treatment group	Empiric treatment group	P value
ITT analysis	75.5% (77/102)	59.0% (59/100)	0.001
PP analysis	90.6% (77/85)	70.2% (59/84)	0.012

ITT: Intention-to-treat analysis; PP: Per-protocol analysis.