Background Helicobacter pylori infection has become increasingly resistant to traditional first-line treatment regimens because of emerging antibiotic resistance coupled with poor patient compliance with completing the treatment course. There is limited data regarding the incidence of H. pylori treatment resistance in the Philippines. This study aims to guide physicians in deciding the choice of the treatment regimen for both treatment-naive and treatment-resistant organisms.

Methods This is a prospective, cohort study in St. Luke’s Medical Center. We currently enrolled 73 patients positive for H. pylori infection based on rapid urease test, and gastroscopy, biopsy of the antrum, incisura and corpus and subsequent H. pylori culture and sensitivity against amoxicillin, clarithromycin, metronidazole, tetracycline, and levofloxacin were done.

Results Thirty-eight percent (38%) or 28 out of 73 patients enrolled are H. pylori culture positive and we were able to isolate and do sensitivity analysis in 42 samples. The incidence rate of Helicobacter treatment-resistant infection is high at 66.7% or 28 out of 42 isolates. Among the medications used, no resistance was noted for amoxicillin and tetracycline, while the resistance rates are as follows for other antibiotics: clarithromycin 28.6% (12/42), metronidazole 40.5% (17/42) and levofloxacin 61.9% (26/42).

Conclusions The rates of resistance to clarithromycin, metronidazole and levofloxacin are high in Filipino H. pylori strains. This is in contrast to the earlier antibiotic susceptibility study by Destura et. al in 2004 in which all isolated strains were sensitive to tested antibiotics. This new pattern of resistance indicates the decreased usefulness of the first line therapy in the Philippines and the need for other treatment regimens is emerging.