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We report <jats:italic>H.\u00a0pylori<\/jats:italic> resistance and antimicrobial utilization patterns for western Honduras, representative of rural Central America<jats:italic>.<\/jats:italic><\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In the context of the western Honduras gastric cancer epidemiology initiative, gastric biopsies from 189 patients were studied for culture and resistance patterns. Antimicrobial utilization was investigated for common <jats:italic>H. pylori<\/jats:italic> treatment regimens from regional public (7 antimicrobials) and national private (4 antimicrobials) data, analyzed in accordance with WHO anatomical therapeutic chemical defined daily doses (DDD) method and expressed as DDD\/1000 inhabitants per day (DID) and per year (DIY).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p><jats:italic>H. pylori<\/jats:italic> was successfully cultured from 116 patients (56% males, mean age: 54), and nearly all strains were <jats:italic>cagA<\/jats:italic>+ and <jats:italic>vacAs1m1<\/jats:italic>+ positive (99% and 90.4%, respectively). Unexpectedly, high resistance was noted for levofloxacin (20.9%) and amoxicillin (10.7%), while metronidazole (67.9%) and clarithromycin (11.2%) were similar to data from Latin America. Significant associations with age, gender, or histology were not noted, with the exception of levofloxacin (28%, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.01) in those with histology limited to non\u2010atrophic gastritis. Total antimicrobial usage in western Honduras of amoxicillin (17.3 DID) and the quinolones had the highest relative utilizations compared with other representative nations.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>We observed significant <jats:italic>H.\u00a0pylori<\/jats:italic> resistance to amoxicillin and levofloxacin in the context of high community antimicrobial utilization. This has implications in Central America for <jats:italic>H. pylori<\/jats:italic> treatment guidelines as well as antimicrobial stewardship programs.<\/jats:p><\/jats:sec>","DOI":"10.1111\/hel.12595","type":"journal-article","created":{"date-parts":[[2019,5,21]],"date-time":"2019-05-21T04:37:32Z","timestamp":1558413452000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["<i>Helicobacter pylori<\/i> antimicrobial resistance and antibiotic consumption in the low\u2010resource Central America setting"],"prefix":"10.1111","volume":"24","author":[{"given":"Vivian","family":"Ortiz","sequence":"first","affiliation":[{"name":"Department of Internal Medicine Yale University New Haven Connecticut"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dagoberto","family":"Estevez\u2010Ordonez","sequence":"additional","affiliation":[{"name":"The Vanderbilt Division of Gastroenterology, Hepatology, and Nutrition Vanderbilt University Medical Center Nashville Tennessee"},{"name":"Division of Gastroenterology and Hepatology University of Alabama at Birmingham Birmingham Alabama"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eleazar","family":"Montalvan\u2010Sanchez","sequence":"additional","affiliation":[{"name":"Hospital de Occidente Santa Rosa de Copan Honduras"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel","family":"Urrutia\u2010Argueta","sequence":"additional","affiliation":[{"name":"Hospital de Occidente Santa Rosa de Copan Honduras"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dawn","family":"Israel","sequence":"additional","affiliation":[{"name":"The Vanderbilt Division of Gastroenterology, Hepatology, and Nutrition Vanderbilt University Medical Center Nashville Tennessee"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Uma S.","family":"Krishna","sequence":"additional","affiliation":[{"name":"The Vanderbilt Division of Gastroenterology, Hepatology, and Nutrition Vanderbilt University Medical Center Nashville Tennessee"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Judith","family":"Romero\u2010Gallo","sequence":"additional","affiliation":[{"name":"The Vanderbilt Division of Gastroenterology, Hepatology, and Nutrition Vanderbilt University Medical Center Nashville Tennessee"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keith T.","family":"Wilson","sequence":"additional","affiliation":[{"name":"The Vanderbilt Division of Gastroenterology, Hepatology, and Nutrition Vanderbilt University Medical Center Nashville Tennessee"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard M.","family":"Peek","sequence":"additional","affiliation":[{"name":"The Vanderbilt Division of Gastroenterology, Hepatology, and Nutrition Vanderbilt University Medical Center Nashville Tennessee"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ricardo","family":"Dominguez","sequence":"additional","affiliation":[{"name":"Hospital de Occidente Santa Rosa de Copan Honduras"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1136-0963","authenticated-orcid":false,"given":"Douglas R.","family":"Morgan","sequence":"additional","affiliation":[{"name":"The Vanderbilt Division of Gastroenterology, Hepatology, and Nutrition Vanderbilt University Medical Center Nashville Tennessee"},{"name":"Division of Gastroenterology and Hepatology University of Alabama at Birmingham Birmingham Alabama"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,5,20]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(13)70318-9"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(13)70195-6"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(14)70780-7"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(14)70071-4"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(11)70054-8"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/clinids\/17.Supplement_2.S346"},{"key":"e_1_2_9_8_1","unstructured":"WHO Europe.Joint annual review meeting on national health strategy of Tajikistan.http:\/\/www.euro.who.int\/en\/countries\/tajikistan\/news\/news\/2011\/11\/joint-annual-review-meeting-onnational-health-strategy-of-tajikistan. 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