Helicobacter pylori antimicrobial resistance in the United Kingdom: the effect of age, sex and socio-economic status

Aliment Pharmacol Ther. 2001 Sep;15(9):1473-8. doi: 10.1046/j.1365-2036.2001.01068.x.


Background: Helicobacter pylori antimicrobial resistance is the most common reason for eradication failure. Small studies have shown metronidazole resistance to be more prevalent in certain population groups.

Aim: To determine the resistance rates in a large cohort of patients from a single centre in the UK, and to evaluate resistance patterns over time, according to age, sex and socio-economic status.

Methods: Consecutive patients with H. pylori-positive antral gastric biopsy samples were studied from 1994 to 1999. Susceptibility testing was performed to metronidazole, tetracycline, macrolide and amoxicillin by the modified disk diffusion

Method: The Jarman under-privileged area score was used as a measure of socio-economic status.

Results: A total of 1064 patients were studied. Overall metronidazole resistance was 40.3%, decreasing with age (P < 0.0001, odds ratio for patients over 60 years 0.63, 95% CI: 0.48-0.80). Women were more likely to have metronidazole resistant strains (P=0.003, odds ratio 1.5, 95% CI: 1.15-1.91), but there was no association with Jarman score. Macrolide resistance was associated with metronidazole resistance (P=0.03, odds ratio 2.14, 95% CI: 1.07-4.28).

Conclusions: Metronidazole resistance in H. pylori is highly prevalent and more common in women and the young, but does not appear to be related to socio-economic status.

MeSH terms

  • Age Distribution
  • Aged
  • Cohort Studies
  • Diagnosis-Related Groups
  • Drug Resistance, Microbial
  • Female
  • Helicobacter pylori / drug effects*
  • Humans
  • Male
  • Metronidazole / pharmacology*
  • Middle Aged
  • Population Surveillance*
  • Sex Distribution
  • Social Class
  • United Kingdom


  • Metronidazole