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Review article: the global emergence of Helicobacter pylori antibiotic resistance
Author(s) -
Thung I.,
Aramin H.,
Vavinskaya V.,
Gupta S.,
Park J. Y.,
Crowe S. E.,
Valasek M. A.
Publication year - 2016
Publication title -
alimentary pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.308
H-Index - 177
eISSN - 1365-2036
pISSN - 0269-2813
DOI - 10.1111/apt.13497
Subject(s) - helicobacter pylori , antibiotic resistance , clarithromycin , medicine , antibiotics , levofloxacin , metronidazole , drug resistance , intensive care medicine , empiric therapy , helicobacter , microbiology and biotechnology , biology
Summary Background Helicobacter pylori is one of the most prevalent global pathogens and can lead to gastrointestinal disease including peptic ulcers, gastric marginal zone lymphoma and gastric carcinoma. Aim To review recent trends in H. pylori antibiotic resistance rates, and to discuss diagnostics and treatment paradigms. Methods A PubMed literature search using the following keywords: Helicobacter pylori , antibiotic resistance, clarithromycin, levofloxacin, metronidazole, prevalence, susceptibility testing. Results The prevalence of bacterial antibiotic resistance is regionally variable and appears to be markedly increasing with time in many countries. Concordantly, the antimicrobial eradication rate of H. pylori has been declining globally. In particular, clarithromycin resistance has been rapidly increasing in many countries over the past decade, with rates as high as approximately 30% in Japan and Italy, 50% in China and 40% in Turkey; whereas resistance rates are much lower in Sweden and Taiwan, at approximately 15%; there are limited data in the USA. Other antibiotics show similar trends, although less pronounced. Conclusions Since the choice of empiric therapies should be predicated on accurate information regarding antibiotic resistance rates, there is a critical need for determination of current rates at a local scale, and perhaps in individual patients. Such information would not only guide selection of appropriate empiric antibiotic therapy but also inform the development of better methods to identify H. pylori antibiotic resistance at diagnosis. Patient‐specific tailoring of effective antibiotic treatment strategies may lead to reduced treatment failures and less antibiotic resistance.