UPDATES IN THE TREATMENT OF HELICOBACTER PYLORI: NEW THERAPEUTIC STRATEGIES AND ANTIMICROBIAL RESISTANCE

Abstract

Helicobacter pylori infection remains an important global public health issue due to its high prevalence and association with chronic gastritis, peptic ulcer disease, gastric adenocarcinoma, and mucosa-associated lymphoid tissue lymphoma. Over recent decades, a progressive reduction in the efficacy of conventional therapeutic regimens has been observed, mainly due to increasing antimicrobial resistance to clarithromycin, levofloxacin, and metronidazole. In this context, the present study aimed to review the main updates in the treatment of H. pylori infection, emphasizing new therapeutic strategies and the impacts of antimicrobial resistance on contemporary clinical practice. This study is an integrative literature review conducted in the PubMed/MEDLINE, SciELO, and Scopus databases using descriptors related to Helicobacter pylori treatment, antimicrobial resistance, and emerging therapies. Articles published between 2015 and 2024 were included, comprising systematic reviews, meta-analyses, randomized clinical trials, international consensus reports, and clinical guidelines. The findings demonstrate that alternative therapies, such as bismuth quadruple therapy, high-dose dual therapy, and vonoprazan-based regimens, have shown promising results in settings of high bacterial resistance. In addition, probiotics, rifabutin, and susceptibility-guided therapies demonstrated potential to optimize eradication rates and reduce therapeutic failures. It is concluded that continuous updating of therapeutic strategies and individualized treatment are essential measures for the effective control of Helicobacter pylori infection in the context of increasing antimicrobial resistance.