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Clinical Implications of Helicobacter pylori Antibiotic Resistance in Italy: A Review of the Literature

Helicobacter pylori (H. pylori) resistance to antibiotics has increased worldwide in recent decades, especially to clarithromycin. As a result, the World Health Organization (WHO) identified clarithromycin-resistant H. pylori as a “high priority” pathogen in 2017. As international guidelines recomme...

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Autores principales: Nista, Enrico Celestino, Pellegrino, Antonio, Giuli, Lucia, Candelli, Marcello, Schepis, Tommaso, De Lucia, Sara Sofia, Ojetti, Veronica, Franceschi, Francesco, Gasbarrini, Antonio
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9598780/
https://www.ncbi.nlm.nih.gov/pubmed/36290110
http://dx.doi.org/10.3390/antibiotics11101452
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author Nista, Enrico Celestino
Pellegrino, Antonio
Giuli, Lucia
Candelli, Marcello
Schepis, Tommaso
De Lucia, Sara Sofia
Ojetti, Veronica
Franceschi, Francesco
Gasbarrini, Antonio
author_facet Nista, Enrico Celestino
Pellegrino, Antonio
Giuli, Lucia
Candelli, Marcello
Schepis, Tommaso
De Lucia, Sara Sofia
Ojetti, Veronica
Franceschi, Francesco
Gasbarrini, Antonio
author_sort Nista, Enrico Celestino
collection PubMed
description Helicobacter pylori (H. pylori) resistance to antibiotics has increased worldwide in recent decades, especially to clarithromycin. As a result, the World Health Organization (WHO) identified clarithromycin-resistant H. pylori as a “high priority” pathogen in 2017. As international guidelines recommend empirical therapy as first-line treatment, it is crucial to know local resistance rates and history of antibiotic use to determine the most appropriate first-line antibiotic treatment. Italy is one of the European countries with the highest prevalence of H. pylori infection and the highest percentage of antibiotic-resistant H. pylori. The aim of this review is to summarize all data on H. pylori antibiotic resistance in Italy in order to quantify the current rate and determine the most effective therapeutic approach. The study confirms an elevated level of resistance to clarithromycin, metronidazole, and levofloxacin in Italy. In addition, our results show a satisfactory eradication rate for a bismuth-based regimen when used as first- or second-line treatment. Naive patients are also successfully treated with clarithromycin-based quadruple therapies. Considering the good results of bismuth-based therapy as recovery therapy, this argues for the potential use of clarithromycin quadruple therapy as a first-line treatment.
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spelling pubmed-95987802022-10-27 Clinical Implications of Helicobacter pylori Antibiotic Resistance in Italy: A Review of the Literature Nista, Enrico Celestino Pellegrino, Antonio Giuli, Lucia Candelli, Marcello Schepis, Tommaso De Lucia, Sara Sofia Ojetti, Veronica Franceschi, Francesco Gasbarrini, Antonio Antibiotics (Basel) Review Helicobacter pylori (H. pylori) resistance to antibiotics has increased worldwide in recent decades, especially to clarithromycin. As a result, the World Health Organization (WHO) identified clarithromycin-resistant H. pylori as a “high priority” pathogen in 2017. As international guidelines recommend empirical therapy as first-line treatment, it is crucial to know local resistance rates and history of antibiotic use to determine the most appropriate first-line antibiotic treatment. Italy is one of the European countries with the highest prevalence of H. pylori infection and the highest percentage of antibiotic-resistant H. pylori. The aim of this review is to summarize all data on H. pylori antibiotic resistance in Italy in order to quantify the current rate and determine the most effective therapeutic approach. The study confirms an elevated level of resistance to clarithromycin, metronidazole, and levofloxacin in Italy. In addition, our results show a satisfactory eradication rate for a bismuth-based regimen when used as first- or second-line treatment. Naive patients are also successfully treated with clarithromycin-based quadruple therapies. Considering the good results of bismuth-based therapy as recovery therapy, this argues for the potential use of clarithromycin quadruple therapy as a first-line treatment. MDPI 2022-10-21 /pmc/articles/PMC9598780/ /pubmed/36290110 http://dx.doi.org/10.3390/antibiotics11101452 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Nista, Enrico Celestino
Pellegrino, Antonio
Giuli, Lucia
Candelli, Marcello
Schepis, Tommaso
De Lucia, Sara Sofia
Ojetti, Veronica
Franceschi, Francesco
Gasbarrini, Antonio
Clinical Implications of Helicobacter pylori Antibiotic Resistance in Italy: A Review of the Literature
title Clinical Implications of Helicobacter pylori Antibiotic Resistance in Italy: A Review of the Literature
title_full Clinical Implications of Helicobacter pylori Antibiotic Resistance in Italy: A Review of the Literature
title_fullStr Clinical Implications of Helicobacter pylori Antibiotic Resistance in Italy: A Review of the Literature
title_full_unstemmed Clinical Implications of Helicobacter pylori Antibiotic Resistance in Italy: A Review of the Literature
title_short Clinical Implications of Helicobacter pylori Antibiotic Resistance in Italy: A Review of the Literature
title_sort clinical implications of helicobacter pylori antibiotic resistance in italy: a review of the literature
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9598780/
https://www.ncbi.nlm.nih.gov/pubmed/36290110
http://dx.doi.org/10.3390/antibiotics11101452
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