Primary resistance of Helicobacter pylori to clarithromycin in different region of Hungary

The resistance of Helicobacter pylori to antimicrobial agents, and particularly to metronidazole and clarithromycin (CLA), is an important factor affecting the outcome of standard treatments for H. pylori eradication. Primer resistance to CLA were found 8.9% in our study in Szeged between 2003 and 2004. Aim: To study the occurrence of CLA-R of in H. pylori-infected patients before eradication therapy in different region of Hungary. Patients: 335H. pylori infected adults suffering from GERD, peptic ulcer disease, erosive gastroduodenitis or nonulcer dyspepsia were undertaken endoscopical examinaton. Of them, 284 living in big cities (Szeged, Szekszárd, Baja,Győr), and 51 patients living in smaler town (Kalocsa) or villages. Methods: Resistance to CLA was investigated histologically by a fluorescent in situ hibridization (FISH) method used on gastric biopsy specimens. Results: H. pylori strains resistant to CLA were found in 31 of 284 (10.91%) patients living in big cities. The prevalence of CLA-resistant H. pylori strains in those living villages was only 1.96% (1/51 patients). Conclusion: These results present a mild increasing tendency of primer resistance to clarithromycin in H. pylori strains between 2003 and 2009 in the big cities. Significant regional differerence may be related to variations of the every day antibiotic practice.