Sequential changes of antibiotic resistances of Helicobacter pylori in Taiwan from 2019 to 2024

Table 1 Baseline characteristics of study population, n (%)

Variables	Patient characteristics (n = 1408)
Age (years), IQR	54.96 (46-65)
Gender
Male	648 (46.02)
Female	760 (53.98)
Cigarette smoking	233 (16.5)
Alcohol drinking	198 (14.1)
Ingestion of coffee	558 (39.6)
Ingestion of tea	569 (40.4)
Endoscopic findings
Gastritis	1005 (71.4)
Gastric ulcer	420 (29.8)
Duodenal ulcer	244 (17.3)
Antibiotic resistance	558 (39.6)
Amoxicillin resistance	18 (1.3)
Clarithromycin resistance	253 (18.0)
Metronidazole resistance	437 (31.0)
Tetracycline resistance	11 (0.8)
Levofloxacin resistance	404 (28.7)

IQR: Interquartile range.

Table 2 Antibiotic resistances in Helicobacter pylori treatment-naive patients from 2019 to 2024 in Taiwan

	Year	Patient number	Proportion, % (95%CI)	P value (χ2 test for linear trend)
Amoxicillin	2019	0/256	0.0 (0.0-0.0)	0.289
	2020	7/330	2.1 (0.6-3.7)
	2021	4/159	2.5 (0.1-5.0)
	2022	1/299	0.3 (0.0-1.0)
	2023	1/249	0.4 (0.0-1.2)
	2024	5/115	4.3 (0.6-8.1)
Clarithromycin	2019	37/256	14.5 (10.1-18.8)	0.514
	2020	65/330	19.7 (15.4-24.0)
	2021	33/159	20.8 (14.4-27.1)
	2022	56/299	18.7 (14.3-23.3)
	2023	34/249	13.7 (9.4-17.9)
	2024	28/115	24.3 (16.4-32.3)
Metronidazole	2019	91/256	35.5 (29.6-41.4)	0.000
	2020	118/330	35.8 (30.5-41.0)
	2021	52/159	32.7 (25.3-40.1)
	2022	86/299	28.8 (23.6-33.9)
	2023	75/249	30.1 (24.4-35.9)
	2024	15/115	13.0 (6.8-19.3)
Tetracycline	2019	0/256	0.0 (0.0-0.0)	0.000
	2020	0/330	0.0 (0.0-0.0)
	2021	1/159	0.6 (0.0-2.0)
	2022	3/299	1.0 (0.0-2.3)
	2023	3/249	1.2 (0.0-2.8)
	2024	4/115	3.5 (0.1-7.2)
Levofloxacin	2019	81/256	31.6 (25.9-37.3)	0.269
	2020	91/330	27.6 (22.7-32.4)
	2021	57/159	35.8 (28.3-43.4)
	2022	76/299	25.4 (20.5-30.4)
	2023	64/249	25.7 (20.2-31.2)
	2024	35/115	30.4 (21.9-39.0)

CI: Confidence interval.

Table 3 Dual resistances in Helicobacter pylori treatment-naive patients from 2019 to 2024 in Taiwan

	Year	Patient number	Proportion, % (95%CI)	P value (χ2 test for linear trend)
Amoxicillin + clarithromycin	2019	0/256	0 (0.0-0.0)	0.720
	2020	2/330	0.6 (0.0-1.0)
	2021	0/159	0 (0.0-0.0)
	2022	1/299	0.3 (0.0-1.1)
	2023	0/249	0 (0.0-0.0)
	2024	1/115	0.9 (0.0-2.9)
Amoxicillin + metronidazole	2019	0/256	0 (0.0-0.0)	0.543
	2020	5/330	1.5 (0.3-3.0)
	2021	2/159	1.3 (0.0-3.2)
	2022	1/299	0.3 (0.0-1.1)
	2023	0/249	0.0 (0.0-0.0)
	2024	1/115	0.9 (0.0-2.9)
Amoxicillin + tetracycline	2019	0/256	0.0 (0.0-0.0)	0
	2020	0/330	0.0 (0.0-0.0)
	2021	0/159	0.0 (0.0-0.0)
	2022	0/299	0.0 (0.0-0.0)
	2023	0/249	0.0 (0.0-0.0)
	2024	0/115	0.0 (0.0-0.0)
Clarithromycin + metronidazole	2019	20/256	7.8 (4.5-11.1)	0.208
	2020	23/330	7.0 (4.2-9.7)
	2021	10/159	6.3 (2.5-10.1)
	2022	21/299	7.0 (4.1-9.9)
	2023	14/249	5.6 (2.7-8.5)
	2024	5/115	4.3 (0.6-8.1)
Clarithromycin + tetracycline	2019	0/256	0.0 (0.0-0.0)	0.013
	2020	0/330	0.0 (0.0-0.0)
	2021	0/159	0.0 (0.0-0.0)
	2022	2/299	0.7 (0.0-1.7)
	2023	1/249	0.4 (0.0-1.3)
	2024	2/115	1.7 (0.0-4.5)
Metronidazole + tetracycline	2019	0/256	0.0 (0.0-0.0)	0.007
	2020	0/330	0.0 (0.0-0.0)
	2021	1/159	0.6 (0.0-2.1)
	2022	2/299	0.7 (0.0-1.7)
	2023	3/249	1.2 (0.0-2.8)
	2024	2/115	1.7 (0.0-4.5)

CI: Confidence interval.

Table 4 Antibiotic resistances of Helicobacter pylori treatment-naive patients across different regions in Taiwan

	Region	Patient number	Proportion, % (95%CI)	P value (χ2 test for linear trend)
Amoxicillin	South	11/818	1.3 (0.6-2.2)	0.606
	North	5/501	1.0 (0.2-1.9)
	East	2/89	2.2 (0.0-5.8)
Clarithromycin	South	144/818	17.6 (15.0-12.2)	0.360
	North	88/501	17.6 (14.2-20.9)
	East	21/89	23.6 (14.6-32.6)
Metronidazole	South	248/818	30.3 (27.2-33.5)	0.784
	North	160/501	31.9 (27.8-36.0)
	East	29/89	32.6 (22.7-42.5)
Tetracycline	South	8/818	1.0 (0.3-1.7)	0.080
	North	1/501	0.2 (0.0-0.6)
	East	2/89	2.2 (0.0-5.8)
Levofloxacin	South	253/818	30.9 (27.8-34.1)	0.044
	North	133/501	26.5 (22.7-30.4)
	East	18/89	20.2 (11.7-28.7)

CI: Confidence interval.