BACKGROUND: Pretreatment antimicrobial resistance has an important impact on the efficacy of many @entity1534 treatment regimens. OBJECTIVE: To estimate the prevalence of @entity1534 resistance to antimicrobials in the United States, to characterize risk factors associated with H. @entity1534 antimicrobial resistance, and to explore the association between drug utilization and antimicrobial resistance patterns over time. DESIGN: Meta-analysis using @entity1 -level data. SETTING: 20 nationwide trials of @entity1534 eradication. @entity1 : 3624 @entity1 and @entity1 , each of whom contributed one isolate. MEASUREMENTS: Rates of @entity1534 resistance to @entity4581 , @entity868 , and @entity115 , according to geographic region, age, sex, study year, ethnicity, @entity1066 status, test method, and study. RESULTS: Overall resistance to @entity4581 , @entity868 , and @entity115 was 10.1% (95% CI, 9.1% to 11.1% [360 of 3571 @entity1 ]), 36.9% (CI, 35.1% to 38.7% [1063 of 2883 @entity1 ]), and 1.4% (CI, 1.0% to 1.8% [48 of 3486 @entity1 ]), respectively. In multivariable analyses, multiple risk factors were associated with resistance to individual agents. @entity4581 resistance was significantly associated with geographic region (P = 0.050), older age (P < 0.001), female sex (P < 0.001), inactive @entity1066 (P < 0.001), and study (P = 0.010). @entity868 resistance was significantly associated with female sex (P < 0.001), earlier year of study enrollment (P = 0.036), Asian ethnicity (P < 0.001), use of an epsilometer test (P = 0.002), and study (P < 0.001). @entity115 resistance was low and was not significantly associated with any risk factor. In the 1990s, when rates for use of oral @entity7187 and @entity868 were relatively stable, @entity4581 resistance rates were stable and @entity868 resistance rates varied. CONCLUSIONS: Clinicians should consider risk factors for antimicrobial resistance when deciding which @entity1 should have susceptibility testing and when choosing appropriate @entity1534 treatments in the empirical setting.

Risk factors for @entity1534 resistance in the United States: the surveillance of H. XXXX antimicrobial resistance partnership (SHARP) study, 1993-1999.

@entity1 :: ('9606', 'Species') :: ['women', 'patients', 'patient', 'PATIENTS', 'men'] @entity868 :: ('MESH:D008795', 'Chemical') :: ['metronidazole', 'Metronidazole'] @entity115 :: ('MESH:D000658', 'Chemical') :: ['Amoxicillin', 'amoxicillin'] @entity4581 :: ('MESH:D017291', 'Chemical') :: ['clarithromycin', 'Clarithromycin'] @entity1066 :: ('MESH:D014456', 'Disease') :: ['ulcer', 'ulcer disease'] @entity7187 :: ('MESH:D018942', 'Chemical') :: ['macrolides'] @entity1534 :: ('210', 'Species') :: ['H. pylori', 'pylori', 'Helicobacter pylori']
@entity1534 :: (210,Species) :: ['pylori']
