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Copyright ©2014 Baishideng Publishing Group Inc.
World J Gastroenterol. Aug 7, 2014; 20(29): 9912-9921
Published online Aug 7, 2014. doi: 10.3748/wjg.v20.i29.9912
Table 1 Proposed clinical antimicrobial breakpoints for Helicobacter pylori
AntibioticSusceptible (mg/L)Resistant (mg/L)
Amoxicillin ≤ 0.12> 0.12
Clarithromycin ≤ 0.25> 0.5
Metronidazole ≤ 8> 8
Levofloxacin ≤ 1> 1
Rifampicin1 ≤ 1> 1
Tetracycline ≤ 1> 1
Table 2 Sensitivity and specificity of molecular tests for detecting Helicobacter pylori antibiotic resistance
Molecular testAntibioticSensitivitySpecificityRef.
PCRClarithromycin82%100%[64]
Genotype HelicoDR assayClarithromycin94%99%[57]
Levofloxacin87%98.5%
PCRClarithromycin90.6%95.8%[59]
PCRClarithromycin89.2%100%[62]
Genotype HelicoDR assayClarithromycin100%86.2%[72]
Levofloxacin82.6%95.1%
PCRClarithromycin83.3%100%[65]
Table 3 Summary of Europe-wide studies on antibiotic resistance rates over time
Antibiotic1991[93]1998[74]2008/9[42]
Metronidazole27.5%33.1%34.9%
ClarithromycinND9.9%17.5%
AmoxicillinND0.8%0.7%
LevofloxacinNDND14.1%
TetracyclineNDND0.9%
RifampicinNDND1.1%
Table 4 Recent data on Helicobacter pylori antibiotic resistance rates in different regions and countries
Ref.RegionAntibiotic resistance rates
ClarMetLevo
Tveit et al[94]Alaska30%242%219%2
Gao et al[71]China; Beijing37.2%263.9%250.3%2
Su et al[83]China; South East coastal region21.5%295.4%220.6%2
McNulty et al[19]England3%222%21%2
Megraud et al[42]Europe; Northern countries7.7%128.6%17.7%1
Megraud et al[42]Europe; Southern countries21.5%129.7%113.1%1
Megraud et al[42]Europe; Western and central countries18.7%143.8%118.6%1
Abadi et al[95]Iran45.2%265.5%234.5%2
O’Connor et al[81]Ireland9.3%129.1%1ND
O’Connor et al[82]13.2%231.5%211.7%2
Yamade et al[84]Japan38.8%1ND34%1
55.6%2ND38.6%2
Lee et al[85]Korea23.7%1ND28.1%1
Seck et al[96]Senegal1%185%115%1
Vilachione et al[70]Thailand3.7%136%17.2%1
McNulty et al[19]Wales18%243%213%2