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Canadian Journal of Gastroenterology
Volume 17, Suppl B, Pages 49B-52B

Helicobacter pylori Resistance to Antibiotics: Prevalence, Mechanism, Detection. What’s New?

Francis Mégraud

Laboratoire de Bactériologie, Université Victor Segalen Bordeaux 2, Bordeaux, France

Copyright © 2003 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Helicobacter pylori resistance to antibiotics is increasingly reported and may limit the efficacy of current treatment regimens. Their resistance mechanism has been found to be point mutations for all antibiotics. Macrolide resistance is the most clinically important, but can be detected efficiently by molecular methods. Metronidazole resistance has limited clinical impact but testing methods are not reliable. Seldomly found cases of resistance, such as to amoxicillin and tetracycline, have had their mechanism recently elucidated. The existance of rapid and practical methods for the detection of macrolide resistance (eg, Fluorescence Resonance Energy Transfer assay) should improve management of H pylori-positive patients in the future, by allowing an adapted first-line therapy.