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©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Oct 21, 2025; 31(39): 111380
Published online Oct 21, 2025. doi: 10.3748/wjg.v31.i39.111380
Published online Oct 21, 2025. doi: 10.3748/wjg.v31.i39.111380
Sequential changes of antibiotic resistances of Helicobacter pylori in Taiwan from 2019 to 2024
Pei-Jui Wu, I-Che Feng, Mitsuhiro Koseki, Ming-Jen Sheu, Division of Hepatogastroenterology, Department of Internal Medicine, Chi Mei Medical Center, Tainan 71004, Taiwan
Feng-Woei Tsay, Division of Gastroenterology and Hepatology, Department of Internal Medicine, Kaoshiung Veterans General Hospital, Kaohsiung 813414, Taiwan
Deng-Chyang Wu, Chao-Hung Kuo, Division of Gastroenterology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung 807377, Taiwan
Jyh-Chin Yang, Division of Gastroenterology, Department of Internal Medicine, National Taiwan University Hospital, Taipei 100229, Taiwan
Seng-Kee Chuah, Division of Hepato-Gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 833253, Taiwan
Kuan-Yang Chen, Division of Gastroenterology and Hepatology, Department of Internal Medicine, Taipei City Hospital, Taipei 10629, Taiwan
Chien-Lin Chen, Department of Medicine, Buddhist Tzu Chi General Hospital and Tzu Chi University, Hualien 970473, Taiwan
Chia-Long Lee, Division of Gastroenterology and Hepatology, Department of Internal Medicine, Cathay General Hospital, Taipei 10650, Taiwan
Chih-An Shih, Division of Gastroenterology and Hepatology, Department of Internal Medicine, Antai Medical Care Corporation, Antai Tian-Sheng Memorial Hospital, Pingtung County 928, Taiwan
Yu-Hwa Liu, Division of Gastroenterology, Department of Internal Medicine, Shin Kong Wu Huo-Shih Memorial Hospital, Taipei 111045, Taiwan
Sz-Iuan Shiu, Division of Gastroenterology and Hepatology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung 407, Taiwan
Wei-Chen Tai, Division of Hepato-Gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 833253, Taiwan
Wei-Chen Tai, Department of Leisure and Sport Management, Cheng Shiu University, Kao
Wei-Yi Lei, Department of Medicine, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation and Tzu Chi University, Hualien 970473, Taiwan
Sung-Shuo Kao, Division of Gastroenterology and Hepatology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung 813414, Taiwan
Tzung-Jiun Tsai, Division of Gastroenterology and Hepatology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung 813414, Taiwan
Ping-I Hsu, Division of Gastroenterology, Department of Internal Medicine, An Nan Hospital, China Medical University, Tainan 709204, Taiwan
Co-first authors: Pei-Jui Wu and Feng-Woei Tsay.
Co-corresponding authors: Ping-I Hsu and Ming-Jen Sheu.
Author contributions: Hsu PI, Sheu MJ designed and conducted the study; Wu PJ wrote the paper; Tsay FW contributed to the analysis and statistics; Wu DC, Yang JC provided clinical advice; Chuah SK, Chen KY, Chen CL, Lee CL, Shih CA, Liu YH, Shiu SI, Tai WC, Kuo CH, Lei WY, Kao SS, Tsai TJ, Feng IC, Koseki M provided clinical data; Hsu PI supervised the study; All authors discussed the results and contributed to the final manuscript; Wu PJ and Tsay FW contributed equally to this work as co-first authors; Hsu PI and Sheu MJ contributed equally to this work as co-corresponding authors.
Supported by the An Nan Hospital, China Medical University, No. ANHRF114-20 and No. ANHRF114-21.
Institutional review board statement: The study protocol was approved by the Institutional Review Board and the Ethics Committee of An Nan Hospital, No. TMANH109-REC002(AR-1) and No. TMANH109-REC025, and patient data were anonymized.
Informed consent statement: The requirement for informed consent was waived.
Conflict-of-interest statement: The research funding was provided by the An Nan Hospital.
Data sharing statement: Dataset available from the corresponding author at williamhsup@yahoo.com.tw.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ping-I Hsu, MD, Professor, Division of Gastroenterology, Department of Internal Medicine, An Nan Hospital, China Medical University, No. 66, Sec. 2, Changhe Road, Tainan 709204, Taiwan. williamhsup@yahoo.com.tw
Received: July 1, 2025
Revised: August 2, 2025
Accepted: September 11, 2025
Published online: October 21, 2025
Processing time: 114 Days and 20.1 Hours
Revised: August 2, 2025
Accepted: September 11, 2025
Published online: October 21, 2025
Processing time: 114 Days and 20.1 Hours
Core Tip
Core Tip: Antibiotic resistance significantly impacts the treatment failure rates of Helicobacter pylori (H. pylori) infections. We analyzed the trends in single and dual resistance profiles of H. pylori treatment-naive Taiwanese between January 2019 and December 2024. Primary antibiotic resistance to tetracycline in H. pylori has increased in Taiwan from 2019 to 2024, while resistance to metronidazole have decreased during the same period. Additionally, the dual resistance to clarithromycin plus tetracycline and metronidazole plus tetracycline both increased significantly. These changes carry major clinical implications: It threatens the efficacy of bismuth-based quadruple therapy and limit the treatment options.