The Unfinished Agenda in Helicobacter pylori Treatment: Resistance, Microbiome Effects, and Future Directions - PubMed
3 hours ago
- #antimicrobial resistance
- #microbiome impact
- #H. pylori
- H. pylori infection is a major cause of peptic ulcer disease, MALT lymphoma, and non-cardia gastric cancer.
- Rising antimicrobial resistance, particularly to clarithromycin, metronidazole, and fluoroquinolones, undermines traditional therapies.
- Susceptibility-guided therapy is effective but limited by infrastructure issues and implementation gaps.
- Eradication regimens can disrupt gut and gastric microbiota and expand the antimicrobial resistome.
- Probiotics and N-acetylcysteine offer only modest improvements in eradication and tolerability.
- Emerging therapies include engineered phage therapy, antimicrobial peptides, nanoparticle-delivered urease inhibitors, biofilm-targeting agents, and vaccines.
- Optimizing treatment requires evidence-based regimen selection, precision-guided strategies, antimicrobial stewardship, and equitable access to medications.