Every year, doctors increasingly encounter H. pylori resistance to antibiotics included in the recommended treatment regimens for this common infection. Clarithromycin, in particular, is rapidly losing its effectiveness.

Helicobacter pylori is a spiral-shaped bacterium that infects the lining of the stomach and duodenum. Nearly 50% of the world's population is infected with H. pylori . In most cases, Helicobacter pylori infection is asymptomatic. However, the bacterium can cause serious illnesses—from gastritis and duodenitis to stomach ulcers—and is the most significant risk factor for stomach cancer. Therefore, if any gastrointestinal symptoms appear, it is important to undergo an examination to determine the cause. If Helicobacter pylori is the cause, the doctor will prescribe a specific combination of medications, two of which are antibiotics.

The problem is that doctors increasingly encounter antibiotic-resistant H. pylori every year. In 2017, the WHO identified the study of antibiotic-resistant H. pylori strains and the search for treatments for them as a priority.

The results of a new study show that the prevalence of resistant Helicobacter strains is increasing worldwide. Scientists analyzed* data from 1,232 patients from 18 European countries and constructed a chart showing the percentage of H. pylori antibiotic resistance cases detected in the population from 1998 to 2018. It turned out that this figure for the antibiotic clarithromycin more than doubled: from 9.9% in 1998 to 21.6% in 2018. Over this period, resistance to the antibiotic levofloxacin increased almost 1.2-fold, reaching 16.3%. Resistance to metronidazole, which was already quite high in 1998, reached almost 40% in 2018.

The highest rates of resistance were found in southern Italy (39.9%), Croatia (34.6%), and Greece (30%). This is explained by the excessive consumption of antibiotics in these countries for the treatment of acute respiratory infections and influenza, as well as the lack of institutional support for strategies to contain antibiotic resistance.

The rise in antibiotic-resistant bacterial strains requires greater responsibility in the prescribing and use of antimicrobial agents, as well as the search for new ways to combat infectious diseases.

*These data were presented at the European Gastroenterology Week in Barcelona (UEG Week 2019)