Antibiotic Resistance Patterns of Helicobacter pylori and Their Impact on Treatment Outcomes

Abstract

Helicobacter pylori infection remains one of the most persistent and clinically significant challenges in gastroenterology, particularly due to its strong association with chronic gastritis, peptic ulcer disease, and gastric malignancies. In recent years, the effectiveness of standard eradication therapies has declined, largely driven by the increasing prevalence of antibiotic-resistant strains. Against this background, the present study aimed to evaluate current patterns of antibiotic resistance in Helicobacter pylori and to examine how these patterns influence treatment outcomes in a real-world clinical setting. A cross-sectional analytical approach was applied, involving 108 adult patients diagnosed with Helicobacter pylori infection. Diagnosis was confirmed through a combination of endoscopic biopsy-based methods and non-invasive testing. Antimicrobial susceptibility was assessed using culture-based techniques, focusing on commonly prescribed antibiotics such as clarithromycin, metronidazole, amoxicillin, and levofloxacin. All patients received standard eradication therapy, and treatment success was evaluated through follow-up testing six weeks after therapy completion. The findings revealed a high prevalence of resistance, particularly to metronidazole and clarithromycin, which significantly reduced eradication success rates. Patients infected with resistant strains showed markedly lower treatment responses compared to those with susceptible strains. Multidrug resistance emerged as the most critical factor associated with treatment failure, underscoring the limitations of empirical therapy.