Editorial
Copyright ©2011 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastrointest Pathophysiol. Jun 15, 2011; 2(3): 35-41
Published online Jun 15, 2011. doi: 10.4291/wjgp.v2.i3.35
Mechanisms of Helicobacter pylori antibiotic resistance: An updated appraisal
Vincenzo De Francesco, Angelo Zullo, Cesare Hassan, Floriana Giorgio, Rosa Rosania, Enzo Ierardi
Vincenzo De Francesco, Floriana Giorgio, Rosa Rosania, Enzo Ierardi, Section of Gastroenterology, Department of Medical Sciences, University of Foggia, Foggia 71100, Italy
Angelo Zullo, Cesare Hassan, Gastroenterology and Digestive Endoscopy, ‘Nuovo Regina Margherita’ Hospital, Rome 00153, Italy
Author contributions: Ierardi E, De Francesco V, Zullo A and Hassan C designed the study, revised the manuscript and approved the final version; Rosania R and Giorgio F collected the data.
Correspondence to: Enzo Ierardi, Professor, Gastroenterology Section, Department of Medical Sciences, University of Foggia, AOU Ospedali Riuniti, Viale Pinto, Foggia 71100, Italy. enzo.ierardi@fastwenet.it
Telephone: +39-0881736204 Fax: +39-0881733848
Received: February 18, 2011
Revised: May 29, 2011
Accepted: June 5, 2011
Published online: June 15, 2011
Abstract

Helicobacter pylori (H. pylori) antibiotic resistance is the main factor affecting the efficacy of the current eradicating therapies. The aim of this editorial is to report on the recent information about the mechanisms accounting for the resistance to the different antibiotics currently utilized in H. pylori eradicating treatments. Different mechanisms of resistance to clarithromycin, metronidazole, quinolones, amoxicillin and tetracycline are accurately detailed (point mutations, redox intracellular potential, pump efflux systems, membrane permeability) on the basis of the most recent data available from the literature. The next hope for the future is that by improving the knowledge of resistance mechanisms, the elaboration of rational and efficacious associations for the treatment of the infection will be possible. Another auspicious progress might be the possibility of a cheap, feasible and reliable laboratory test to predict the outcome of a therapeutic scheme.

Keywords: Helicobacter pylori; Clarithromycin; Metronidazole; Levofloxacin; Amoxicillin; Tetracycline; Resistance; Antibiotic; Point mutation