Antibiotic Susceptibility Assessment of Helicobacter pylori Isolates by Disk-Diffusion Method

The prevalence of clarithromycin-resistant Helicobacter pylori isolates: a systematic review and meta-analysis

Background

Knowledge of global clarithromycin (CLA)-resistant rates of Helicobacter pylori (H. pylori) is crucial for decision of the most appropriate eradication therapies with good clinical outcomes. Therefore, this review and meta-analysis aimed to evaluate the global prevalence of the CLA resistance in H. pylori to provide some guidance for selecting the first-line antibiotics.

Method

A comprehensive search was performed for relevant literature until April 2021 in PubMed, Embase, and Web of Science databases. Freeman-Tukey double arcsine transformation was performed to estimate the weighted pooled prevalence of resistance.

Results

The meta-analysis included 248 articles. The prevalence of CLA-resistant H. pylori was 27.53% (95% CI [25.41-29.69]). The heterogeneity between reports was significant (I² = 97.80%, P < 0.01). The resistance rate increased from 24.28% in 2010-2017 to 32.14% in 2018-2021 (P < 0.01). Iran, with 38 articles, has the most report. Nevertheless, Switzerland, Portugal, and Israel had the highest resistance rates (67.16%, 48.11%, and 46.12%, respectively). The heterogeneity between the continents and the antimicrobial susceptibility methods also interpreted standard guidelines and breakpoints was insignificant (P > 0.05).

Conclusion

Overall CLA resistance rate was 27.53%, worldwide. The difference in CLA resistance rate among the included studies can be due to several reasons such as differences in antibiotic prescription rates in various geographic areas, use of different breakpoints or inaccurate criteria in performed studies, and the emergence of multidrug-resistant (MDR) strains.

Management of H. pylori Induced Peptic ulcer – A Phytotherapeutic Approach

A peptic ulcer is a chronic infectious disease that creates erosion on the epithelial lining of the stomach. It is a commonly encountered problem in the gastrointestinal tract (GI tract). Patients failed multiple regimens due to resistant H. pylori infection. H. pylori show maximum resistance towards Clarithromycin. Due to the consistent increase in resistance there is urgent need for the development of new drugs. Paying much for the antibiotic treatment one should go for the natural treatments with no side effects. Modern treatment of peptic ulcers emphasizes diet with routinely recommend hospitalization of several weeks. Currently, a lot of medications are coming out of natural products. The phytotherapeutic approach for the resistant H.pylori treatment is assessed. The plant produces many secondary metabolic substances which have a lot of beneficial roles in maintaining human health. Administration of plant products would prevent disease and able to eradicate resistant H.pylori. This review includes many phytoproducts having a wide range of antimicrobial activity. Reviewed phytoproducts includes Phytoceutical, Caffeic acid, phenethyl ester, Flavonoid, Capsaicin, Carotenoid, etc are effective treatment against H.pylori. To see their effect on the resistant H.pylori and to manage this resistant bacteria with an application of plant products is the prime concern of this review. The linkage between phytochemical and peptic ulcers will provide a novel framework for the future.