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Review
. 2023 Feb 27:14:1128497.
doi: 10.3389/fmicb.2023.1128497. eCollection 2023.

Multidrug resistance in Helicobacter pylori infection

Raluca Ioana Dascălu  1 , Alexandra Bolocan  2   3 , Dan Nicolae Păduaru  2   3 , Alexandru Constantinescu  2   3 , Magda Mihaela Mitache  4 , Anca Daniela Stoica  5   6 , Octavian Andronic  2   3   7
Affiliations
Review

Multidrug resistance in Helicobacter pylori infection

Raluca Ioana Dascălu et al. Front Microbiol. .

Abstract

Helicobacter pylori (Hp), a well-known human pathogen, causes one of the most common chronic bacterial infections and plays an important role in the emergence of chronic progressive gastric inflammation and a variety of gastrointestinal diseases. The prevalence of Hp infection varies worldwide and is indirectly proportional to socio-economic status, especially during childhood. The response to the eradication therapy significantly depends on the antibiotic resistance specific to each geographical region; thus, currently, given the increasing prevalence of antimicrobial resistance (especially to clarithromycin, metronidazole, and levofloxacin), successful treatment for Hp eradication has become a real challenge and a critical issue. The most incriminated factors associated with multidrug resistance (MDR) in Hp proved to be the overuse or the improper use of antibiotics, poor medication adherence, and bacterial-related factors including efflux pumps, mutations, and biofilms. Up to 30% of first-line therapy fails due to poor patient compliance, high gastric acidity, or high bacteremia levels. Hence, it is of great importance to consider new eradication regimens such as vonoprazan-containing triple therapies, quintuple therapies, high-dose dual therapies, and standard triple therapies with probiotics, requiring further studies and thorough assessment. Strain susceptibility testing is also necessary for an optimal approach.

Keywords: Helicobacter pylori; antibiotic; eradication; infection; multidrug resistance.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The handling editor MCC declared a past co-authorship with the author AB.

Figures

Figure 1
Figure 1
Prevalence of MDR rate (%) by region.
See this image and copyright information in PMC

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