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Helicobacter pylori resistance to current therapies

Smith, Sinéad M.; O’Morain, Colm; McNamara, Deirdre

Current Opinion in Gastroenterology: January 2019 - Volume 35 - Issue 1 - p 6–13
doi: 10.1097/MOG.0000000000000497

Purpose of review Helicobacter pylori eradication rates have fallen in recent years, mainly because of the emergence of antibiotic-resistant infections. Indeed the WHO has recently designated clarithromycin-resistant H. pylori infection a high priority for antibiotic resistance research and development. This review aims to discuss the most up-to-date information on the methods to detect H. pylori antibiotic resistance, the recent data on resistance rates, and the most appropriate treatment strategies to overcome antibiotic resistance.

Recent findings There has been active research into the development and assessment of genotypic diagnostic assays for both the invasive and noninvasive detection of antibiotic-resistant infection. There are regional variations in the prevalence of H. pylori antibiotic resistance. Primary resistance rates in general are on the rise and high rates of clarithromycin resistance (>15%) have been reported in many parts of the world.

Summary Optimizing antimicrobial susceptibility testing by both invasive and noninvasive means is crucial to accurately evaluate resistance rates for the optimization of both regional and personalized H. pylori treatment strategies.

School of Medicine, Trinity College Dublin, Dublin 2, Ireland

Correspondence to Sinéad M. Smith, Room 1.46, Department of Clinical Medicine, Trinity Centre, Tallaght University Hospital, Dublin 24, Ireland. Tel: +35318962998; e-mail:

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