Antibiotic Resistance of Helicobacter pylori: Worldwide Prevalence, Mechanisms and Impact on Therapy

Abstract

H. pylori antibiotic resistance is the main factor affecting the efficacy of the current H. pylori eradicating therapies. Epidemiological aspects and different resistance mechanisms (point mutations, redox intracellular potential, pump efflux systems, membrane permeability) to clarithromycin, metronidazole, quinolones, amoxicillin and tetracycline, are accurately detailed on the basis of the most recent data available from the literature. In addition, the impact of resistance toward each antibiotic on efficacy of current therapies is thoroughly described.

Keywords: Helicobacter pylori, epidemiology, therapy, eradication, antibiotic, resistance, clarithromycin, metronidazole, amoxicillin, levofloxacin, tetracycline, rifabutin, quinolones, point mutation, efflux pump.