Primary Resistance Pattern of Helicobacter pylori to Antibiotics in Adult Population: A Systematic Review

Figures & data

Figure 1 PRISMA flow chart representation showing the overall searching and article selection process of a study Helicobacter pylori primary resistance pattern to antibiotics.

Note: Adapted from Moher D, Liberati A, Tetzlaff J, Altman DG, The PRISMA Group (2009) Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement. PLoS Med 6(7): e1000097. https://doi.org/10.1371/journal.pmed.1000097.¹⁸

Table 1 Primary Resistance Pattern of Helicobacter pylori to Antibiotics Across Different Countries 2015–2017

Author(s) and Year	Country	No. of Participants (n)	Study Period	Prevalence of Primary Antibiotic Resistance
				AMX	CLR	MTR	LVX
Zhang et al 2015^Citation21	China	375	2009–10	0.067(0.0478–0.0996)	0.399(0.3517–0.4504)	0.668(0.6202–0.7150)	0.345(0.3003–0.3962)
Zhang et al 2015^Citation21	China	950	2013–14	0.044(0.0329–0.0592)	0.526(0.4945–0.5579)	0.638(0.6079–0.6689)	0.548(0.5166–0.5798)
Caliskan et al 2015^Citation24	Turkey	98	2012–13	0	0.367(0.2786–0.4661)	0.355(0.2693–0.4557)	0.295(0.2146–0.3926)
Ferenc et al 2017^Citation25	Poland	67	2011–13	0	0.552(0.4336–0.6652)	0.567(0.4481–0.6790)	0.059(0.0235–0.1437)
Ang et al 2016^Citation26	Singapore	170	2012–14	0.041(0.0201–0.0825)	0.171(0.1215–0.2343)	0.482(0.4085–0.5570)	0.147(0.1016–0.2081)
Boehnke et al 2017^Citation27	Peru	76	2011–13	0.329(0.2338–0.4406)	0.355(0.2570–0.4674)	0.618(0.5060–0.7194)	0.539(0.4282–0.6469)
Tamayo et al 2017^Citation28	Spain	91	2014–15	NA	0.077(0.0378–0.1504)	NA	NA
Shiota et al 2015^Citation29	America	110	2009–13	0	0.145(0.0916–0.2233)	0.173(0.1135–0.2541)	0.291(0.2142–0.3817)
Eng et al 2015^Citation30	Canada	20	2012–13	0	0.40(0.2188–0.6134)	0.35(0.1812–0.5671)	0.30(0.1455–0.5190)
Sanches et al 2016^Citation31	Brazil	490	2012–15	NA	0.169(0.1388–0.2051)	NA	NA
Miftahussurur et al 2016^Citation32	Nepal	42	2012	0	0.214(0.1171–0.3594)	0.881(0.7500–0.9481)	0.429(0.2912–0.5779)
Liou et al 2015^Citation33	Taiwan	1395	2000–12	0.023(0.0169–0.0330)	0.112(0.0970–0.1302)	0.257(0.2351–0.2809)	0.088(0.0744–0.1042)
Bouihat et al 2016^Citation34	Morocco	177	2014	0	0.254(0.1958–0.3231)	0.401(0.3318–0.4747)	0.107(0.0698–0.1616)
Zaki et al 2016^Citation35	Egypt	46	2014–15	0.478(0.3412–0.6186)	0.608(0.4646–0.7361)	0.217(0.1226–0.3557)	NA
Harrison et al 2017^Citation36	Nigeria	111	2010–13	0.333(0.2525–0.4253)	0.144(0.0907–0.2214)	0.991(0.9507–0.9984)	NA

Abbreviations: AMX, amoxicillin; CLR, clarithromycin; LVX, levofloxacin; MTR, metronidazole; NA, not analyzed.

Table 2 Overall Primary Resistance Pattern of Helicobacter pylori to Antibiotics in Adult Population Across Different Continents 2015–2017

Country	No. of Participants	Overall Prevalence of Primary Antibiotic Resistance
		AMX	CLR	MTR	LVX
Europe	256	0	0.3125(0.2588–0.3717)	0.2852(0.2333–0.3433)	0.1289(0.0933–0.1755)
North America	130	0	0.1850(0.1273–0.2600)	0.2000(0.1403–0.2769)	0.2923(0.2210–0.3756)
South America	566	0.0442(0.0301–0.0644)	0.1943(0.1639–0.2290)	0.0830(0.0630–0.1087)	0.0724(0.0538–0.0968)
Asia	2732	0.0395(0.0328–0.0478)	0.3093(0.2922–0.3269)	0.4890(0.4703–0.5078)	0.2990(0.2822–0.3165)
Africa	334	0.1766(0.1395–0.2212)	0.2665(0.2219–0.3163)	0.5719(0.5183–0.6238)	0.0569(0.0367–0.0871)
Overall	4218	0.0455(0.0396–0.0522)	0.2722(0.2589–0.2858)	0.3966(0.3820–0.4115)	0.2248(0.2124–0.2376)

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