The problem of antibiotic resistance in the treatment of Helicobacter pylori infection
Abstract
Timely and adequate treatment of Helicobacter pylori (H. pylori) infection is essential, bearing in mind the high prevalence rate (>50%), the fact that infection with this pathogen causes chronic gastritis as well as significant complications in the form of ulcer disease, MALT lymphoma, metaplasia and adenocarcinoma of the stomach. Numerous national recommendations and international guidelines dictate the effectiveness of therapy, but their inconsistent implementation disrupts the cure rate and increases the possibility of developing antibiotic resistance. According to preliminary data, the rate of resistance in Serbia is high. The goal of therapeutic guidelines should be efficient therapy, which is safe and which, if possible, prevents the growing resistance to antibiotics. New diagnostic techniques such as bacterial culture and PCR can facilitate diagnosis and determine antibiotic resistance, which further leads to the possible application of a tailored made therapy that can enable a better cure rate by preventing further antibiotic resistance
References
LITERATURA:
1. Hooi JKY, Lai WY, Ng WK, et al. Global prevalence of Helicobacter pylori infection: systematic review and meta-analysis. Gastroenterology 2017; 153: 420–429.
2. Nyssen OP, Bordin D, Tepes B On behalf of the Hp-EuReg Investigators, et al. European Registry on Helicobacter pylori management (Hp-EuReg): patterns and trends in first-line empirical eradication prescription and outcomes of 5 years and 21 533 patients. Gut. 2021;70:40-54.
3. Thung I, Aramin H, Vavinskaya V, et al. Review article: the global emergence of Helicobacter pylori antibiotic resistance. Aliment Pharmacol Ther 2016; 43: 514–533.
4. Megraud F, Coenen S, Versporten A, et al. Helicobacter pylori resistance to antibiotics in Europe and its relationship to antibiotic consumption. Gut 2013; 62: 34–42
5. Bujanda L, Nyssen OP, Vaira D, Saracino IM, Fiorini G, Lerang F, et al. Antibiotic Resistance Prevalence and Trends in Patients Infected with Helicobacter pylori in the Period 2013-2020: Results of the European Registry on H. pylori Management (Hp-EuReg). Antibiotics (Basel). 2021 Sep 1;10(9).
6. Megraud F, Bruyndonckx R, Coenen S, et al. Helicobacter pylori resistance to antibiotics in Europe in 2018 and its relationship to antibiotic consumption in the community. Gut 2021;70:1815–1822
7. Milivojevic V, Kekic D, Ranin L, Medic B, et al. Primary and secondary Helicobater pylori resistance among Serbian adult pupaltion. Helicobacter, 2019 1 (Vol. 24). Kaunas, September 2019.
8. Savoldi, A.; Carrara, E.; Graham, D.Y.; Conti, M.; Tacconelli, E. Prevalence of Antibiotic Resistance in Helicobacter pylori: A Systematic Review and Meta-analysis in World Health Organization Regions. Gastroenterology 2018, 155, 1372–1382.e17.
9. Milivojevic V, Milosavljevic T. Review –Treatment of Helicobacter pylori infection. Microb Health Dis 2021; 3: e525
10. Mascellino MT, Porowska B, De Angelis M, et al. Antibiotic susceptibility, heteroresistance, and updated treatment strategies in Helicobacter pylori infection. Drug Des Dev Ther 2017; 11: 2209–2220.
11. Arslan N, Yilmaz O and Demiray-Gurbuz E. Importance of antimicrobial susceptibility testing for the management of eradication in Helicobacter pylori infection. World J Gastroenterol 2017; 23: 2854–2869
12. Ierardi E, Giorgio F, Iannone A, et al. Noninvasive molecular analysis of Helicobacter pylori: is it time for tailored first-line therapy? World J Gastroenterol 2017; 23: 2453–2458.
13. Malfertheiner P, Megraud F, O’Morain CA, et al. Management of Helicobacter pylori infection-the Maastricht V/Florence Consensus Report. Gut 2017; 66: 6–30.
14. Malfertheiner P, Megraud F, Rokkas T, et al. Management of Helicobacter pylori infection: the Maastricht VI/Florence consensus report. Gut 2022;71:1724–1762.
15. Wenzhen Y, Yumin L, Quanlin G, et al. Is antimicrobial susceptibility testing necessary before first-line treatment for Helicobacter pylori infection? Meta-analysis of randomized controlled trials. Intern Med 2010; 49: 1103–1109.
16. Chen H, Dang Y, Zhou X, et al. Tailored therapy versus empiric chosen treatment for Helicobacter pylori eradication: a meta-analysis. Medicine (Baltimore) 2016; 95: e2750.
17. Espada M, Nyssen OP and Gisbert JP. Empirical versus susceptibility-guided treatment of Helicobacter pylori infection: a meta-analysis. Helicobacter 2020; 25(Suppl. 1): 26.
18. Huang HT, Wang HM, Yang SC, et al. Efficacy of a 14-day quadruple-therapy regimen for thirdline Helicobacter pylori eradication. Infect Drug Resist 2018; 11: 2073–2080.
19. Cammarota G, Ianiro G, Bibbo S, et al. Cultureguided treatment approach for Helicobacter pylori infection: review of the literature. World J Gastroenterol 2014; 20: 5205–5211.