THERAPEUTIC APPROACHES FOR ANTIBIOTIC-RESISTANT HELICOBACTER PYLORI: CURRENT STRATEGIES AND FUTURE PERSPECTIVES

Abstract

Antibiotic-resistant Helicobacter pylori infection has emerged as a major global health concern, significantly reducing the effectiveness of conventional eradication therapies.

Resistance to clarithromycin, metronidazole, and levofloxacin has led to persistent gastritis, recurrent peptic ulcers, and increased risk of gastric malignancies. Regional variations in resistance patterns complicate empirical treatment and necessitate tailored therapeutic approaches. Modern strategies, including bismuth-containing quadruple therapy, sequential and concomitant regimens, and molecular-guided personalized treatments, have improved eradication outcomes. Adjunctive measures such as probiotics and optimized acid suppression further enhance treatment efficacy. Ongoing research into novel antibiotics, vaccines, and alternative delivery systems offers promising solutions for the long-term management and prevention of resistant infections. This review emphasizes the importance of integrating clinical, molecular, and public health strategies to reduce the global burden of antibiotic-resistant H. pylori.