Antibiotic resistance, susceptibility testing and stewardship in Helicobacter pylori infection

Abstract

It is promising to observe a worldwide decrease in the prevalence of Helicobacter pylori (H. pylori), yet consistent efforts are required to enhance treatment regimens in accordance with antibiotic stewardship in the era of growing antibiotic resistance. Various molecular mechanisms are responsible for antibiotic resistance, and thanks to technological advancements, our understanding of these mechanisms has improved, which facilitated the assessment of antibiotic susceptibility to H. pylori. Progress made in next-generation sequencing technology could potentially herald a new era, encouraging the routine use of non-invasive tests to gather data on antibiotic resistance. It is crucial that studies and clinical guidelines ensure the proposed treatment can consistently meet an acceptable level of eradication rate, taking into account the variations in antibiotic resistance across different populations. Future investigations should strive to refine the duration and dosage and reduce side effects of treatment regimens. Through personalized medicine, better treatment strategies can be formulated. It is equally important to actively encourage patient adherence to these treatments through all available strategies. Collaboration among local, regional, and international bodies is necessary to reinforce antibiotic stewardship in H. pylori treatment.