Antibiotic Resistance of Helicobacter pylori in Iranian Children: A Systematic Review and Meta-Analysis

• Published in: Microbial drug resistance (Larchmont, N.Y.) Vol. 24; no. 7; pp. 98 - 986
• Main Authors: Yousefi-Avarvand, Arshid, Vaez, Hamid, Tafaghodi, Mohsen, Sahebkar, Amir Hossein, Arzanlou, Mohsen, Khademi, Farzad
• Format: Journal Article
• Language: English
• Published: United States Mary Ann Liebert, Inc 01.09.2018
• Subjects: Age; Amoxicillin; Ampicillin; Anti-Bacterial Agents - therapeutic use; Antibiotic resistance; Antibiotics; Antimicrobial agents; Azithromycin; Child; Children; Ciprofloxacin; Clarithromycin; Developing countries; Drug resistance; Drug Resistance, Bacterial - drug effects; Epidemiology; Erythromycin; Furazolidone; Gastroenterology; Helicobacter Infections - drug therapy; Helicobacter Infections - microbiology; Helicobacter pylori; Helicobacter pylori - drug effects; Humans; Infections; Iran; LDCs; Literature reviews; Medicine; Meta-analysis; Metronidazole; Nitrofurantoin; Pediatrics; Rifampin; Studies; Systematic review; Iran; Iran; antibiotic resistance; children; Helicobacter pylori
• ISSN: 1076-6294; 1931-8448
• DOI: 10.1089/mdr.2017.0292

Antibiotic therapy for children infected with Helicobacter pylori is important. However, resistance to antibiotics is one of the main causes of treatment failure. This study was designed to evaluate the prevalence pattern of antibiotic resistance of H. pylori in Iranian children using a systematic review and meta-analysis of literature. A computerized search (until June 10, 2017) using related keywords in the national and international databases was performed. A total of 261 original articles on antibiotic resistance of H. pylori in Iranian children were collected. After screening for inclusion and exclusion criteria, six eligible articles were included in the meta-analysis. Resistance rates of H. pylori to different antibiotics were as follows: metronidazole: 71%, clarithromycin: 12.2%, amoxicillin: 20.4%, tetracycline: 8.4%, ampicillin: 21.4%, rifampin: 28.6%, furazolidone: 8.4%, ciprofloxacin: 16.2%, azithromycin: 19%, erythromycin: 15.3%, and nitrofurantoin: 0%. The prevalence of H. pylori resistance to metronidazole, amoxicillin, ampicillin, and rifampin among Iranian children was high. Therefore, a careful monitoring of antibiotic resistance to select the best treatment options and prevent treatment failure is required. Although resistance to some antibiotics such as clarithromycin, tetracycline, furazolidone, and ciprofloxacin was less prevalent, frequent consumption of these drugs in children should be controlled owing to their known adverse events.