A European study published in the scientific journal Gut Microbes confirms an increase in the resistance of Helicobacter pylori to some of the most commonly used antibiotics for its eradication. This compromises treatment efficacy and necessitates strengthening surveillance strategies and the rational use of antimicrobials.
The research, led by the CIBER of Hepatic and Digestive Diseases (CIBEREHD) at the Biogipuzkoa Health Research Institute and the University of the Basque Country (UPV/EHU), with collaboration from the University Hospital of La Princesa, analyzed data from over 170,000 patients across 31 European countries between 1990 and 2024.
Results show that primary resistance to clarithromycin has reached 24% in the most recent period (2020-2024), and resistance to levofloxacin stands at 21%. Both figures exceed the 15% threshold set by European clinical guidelines, beyond which empirical use of these antibiotics is no longer recommended.
Resistance to metronidazole reaches 33%, while resistance to amoxicillin, tetracycline, and rifampicin remains low (2.3%, 1%, and 4%, respectively). The analysis also reveals geographical differences, with higher resistance rates in Southern European countries, including Spain.
H. pylori infection affects approximately 40% of the global population and is a risk factor for gastric cancer. The emergence of resistance significantly reduces the chances of therapeutic success, leading the research team to emphasize the importance of adapting strategies to the epidemiological reality.
The study underscores the need to update clinical treatment guidelines, reinforce prudent antibiotic use policies, and promote the establishment of sentinel centers to systematically collect clinical samples and microbiological data. These systems would allow for monitoring resistance evolution, early detection of changes, and providing essential information for decision-making by health authorities.
