Overcoming antibiotic-resistant Helicobacter pylori infection:Current challenges and emerging approaches  

作　　者：Gabriel Reis Rocha Fabian Fellipe Bueno Lemos Luis Guilherme de Oliveira Silva Marcel Silva Luz Gabriel Lima Correa Santos Samuel Luca Rocha Pinheiro Mariana Santos Calmon Fabrício Freire de Melo 

机构地区：[1]Instituto Multidisciplinar em Saúde,Universidade Federal da Bahia,Vitória da Conquista 45029-094,Bahia,Brazil

出　　处：《World Journal of Gastroenterology》2025年第10期7-29,共23页世界胃肠病学杂志(英文)

基　　金：Supported by the Industrial Technological Initiation Scholarship of National Council for Scientific and Technological Development,CNPq,Brazil,No.0932204294929829 and No.7414780530977345;the Scientific Initiation Scholarship Programme(PIBIC)of National Council for Scientific and Technological Development,CNPq,Brazil,No.5763023359532159,No.6472982965854452,and No.7340128440641417;the Scientific Initiation Scholarship Programme(PIBIC)of Bahia State Research Support Foundation,FAPESB,Brazil,No.19.573.301.5418;the PERMANECER Programme of Pro-Rectory of Student Assistance at Federal University of Bahia,No.R8EZ-4V4W-6LQX-5LC8;the CNPq Research Productivity Fellow,No.4357511882624145.

摘　　要：Recent studies have shown a noticeable increase in global Helicobacter pylori(H.pylori)resistance,with clarithromycin resistance surpassing 15%in various areas.However,inadequate epidemiological monitoring,especially in developing countries,and the absence of uniform testing methods lead to discrepancies between regions and a possible underestimation of resistance levels.The complexity of treating H.pylori is driven by its highly dynamic genome,which is prone to frequent mutations contributing to phenotypical resistance.The usual course of action in empirical treatment involves using a combination of various drugs simultaneously,leading to significant resistance selection pressure and potential side effects.The emergence of H.pylori strains resistant to multiple drugs is closely tied to failures in first-line treatment,highlighting the need to prevent further resistance by using optimal initial empirical therapy or regimens guided by antibiotic susceptibility testing,requiring a collection of mixed samples and multiple isolates for accurate assessment.The emergence of new treatments like potassium-competitive acid blockers offers a hopeful approach to decrease antimicrobial usage while still ensuring effectiveness in comparison to traditional therapies with proton pump inhibitors.Additionally,the use of probiotics is under investigation to identify specific strains and formulations that may mitigate therapy-associated adverse effects.

关 键 词：Helicobacter pylori Antibiotic resistance Multidrug resistance HETERORESISTANCE Empirical treatment Antimicrobial susceptibility testing 

分 类 号：R573[医药卫生—消化系统]