AUTHOR=Dascălu Raluca Ioana , Bolocan Alexandra , Păduaru Dan Nicolae , Constantinescu Alexandru , Mitache Magda Mihaela , Stoica Anca Daniela , Andronic Octavian 

TITLE=Multidrug resistance in Helicobacter pylori infection

JOURNAL=Frontiers in Microbiology

VOLUME=Volume 14 - 2023

YEAR=2023

URL=https://www.frontiersin.org/journals/microbiology/articles/10.3389/fmicb.2023.1128497

DOI=10.3389/fmicb.2023.1128497

ISSN=1664-302X

ABSTRACT=elicobacter pylori (Hp), a well-known human pathogen causes one of the most common chronic bacterial infections, playing an important role in the emergence of chronic progressive gastric inflammation and a variety of gastro-intestinal diseases. The prevalence of Hp infection varies worldwide, indirectly proportional to the 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 the 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 patient’s 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.