Abstract: Objective To investigate the medication compliance of patients with Helicobacter pylori （Hp） infection and its impact on pathogen resistance. Methods Patients who underwent gastroscopy at Haikou Hospital of Traditional Chinese Medicine from July 2020 to December 2022 and were confirmed to be Hp‐positive were selected for the study. A self‐designed questionnaire was used to collect general demographic data of the patients. After completing the anti‐Hp treatment, Morisky medication compliance questionnaire was used for investigation. Pretreatment gastric mucosal samples were collected for Hp resistance analysis. The descriptive analysis was used to analyze the medication compliance and drug resistance of Hp infected individuals. Univariate and multivariate analysis methods were used to analyze the impact of medication compliance on pathogen resistance in Hp infected individuals. Results Among a total of 2 112 patients with Hp infection, 1 509 had good medication compliance, accounting for 71.44%. Among 2 112 Hp infected patients, 2 112 Hp strains were obtained, of which 126 were sensitive （5.97%）, 763 were single drug resistant （36.13%）, 559 were double drug resistant （26.47%）, and 664 were multiple drug resistant （31.43%）. The highest resistance rates of Hp to metronidazole and clarithromycin were 51.18% and 20.26%, respectively. Multi classification ordered logistic regression analysis showed that the use of ≥ 4 types of antibiotics （OR=1.881）, retreatment （OR=1.702）, insufficient medication compliance （OR=2.787）, use of levofloxacin within the past 3 months （OR=1.179）, use of amoxicillin within the past 3 months （OR=1.754）, and use of cefuroxime within the past 3 months （OR=1.991） were independent risk factors for Hp resistance. Conclusions Patients with Hp infection have poor medication compliance, and their drug resistance status is relatively severe. It is necessary to strengthen the management of medication compliance and drug resistance monitoring for Hp infected patients, and use drugs reasonably based on the drug resistance monitoring results.

Key words: Helicobacter pylori, Medication compliance, Drug resistance, Influencing factor