Regional Antibiotic Resistance of Helicobacter pylori - Abstract
Antibiotic resistance is considered the cause of unsuccessful eradication of
Helicobactor pylori (H. pylori) infections. Awareness of regional resistance rates of
H. pylori isolates can improve not only empiric antibiotic therapy but also lead to
the development of second line treatment and rescue regimens. At present, the most
common treatment is empiric eradication. Global regional regimen therapies should
be based upon regional in vitro antibiotic resistance rates. This approach is crucial
in successfully treating the individual patient. However, in regions where antibiotic
susceptibility testing is unavailable, epidemiological data for secondary H. pylori
resistance are essential for the judicious use of antibiotics following several treatment
failures. Primary H. pylori resistance to clarithromycin is less prevalent worldwide than
H. pylori resistance to metronidazole. Secondary resistance that develops in vivo in
previously susceptible organisms has been documented in cases of therapeutic failures.
All antibiotics used to treat H. pylori are widely used to treat other bacterial infections.
Pretreatment exposure of H. pylori to inadequate levels of these drugs as well as
the use of inadequate regional antibiotics is associated with secondary resistance.
Herein, we review regional resistance rates of H. pylori isolates to clarithromycin,
metronidazole and levofloxacin, the main antimicrobial agents used for eradication
of H. pylori.