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lüll Worldwide H pylori antibiotic resistance: a systematic review De Francesco V; Giorgio F; Hassan C; Manes G; Vannella L; Panella C; Ierardi E; Zullo AJ Gastrointestin Liver Dis 2010[Dec]; 19 (4): 409-14BACKGROUND AND AIMS: Prevalence of H. pylori antibiotic resistance is increasing worldwide, and it is the main factor affecting efficacy of current therapeutic regimens. Our aim was to review recent data on H. pylori resistance towards antibiotics in different countries. METHODS: A systematic review of studies concerning primary H. pylori antibiotic resistance published through January 2006 to December 2009 was performed. Data were analyzed according to geographic area, age, sex, and gastroduodenal pathology. RESULTS: The overall H. pylori antibiotic resistance rates were 17.2% (95% CI: 16.5-17.9%) for clarithromycin, 26.7% (95% CI: 25.2-28.1%) for metronidazole, 11.2% (95% CI: 9.6-12.7%) for amoxycillin, 16.2% (95% CI: 14.4-18%) for levofloxacin, 5.9% (95% CI: 4.7-7.1%) for tetracycline, 1.4% (95% CI: 0.81-9%) for rifabutin and 9.6% (95% CI: 8.5-10.7%) for multiple antibiotics. Prevalence rate of clarithromycin, metronidazole, and levofloxacin resistance significantly increased from Europe to Asia, America and Africa. Tetracycline resistance is low (<3%) in all countries, but Africa (43.9%). Prevalence of clarithromycin resistance was higher in non-ulcer dyspepsia patients, whilst metronidazole resistance was higher in peptic ulcer patients. Both resistances were significantly higher in female than in male patients. Data regarding amoxicillin resistance are highly conflicting. CONCLUSION: The worldwide H. pylori antibiotic resistance towards different antibiotics has increased. Such a phenomenon may affect therapeutic management in different countries.|*Drug Resistance, Bacterial[MESH]|*Global Health[MESH]|Africa/epidemiology[MESH]|Americas/epidemiology[MESH]|Anti-Bacterial Agents/*therapeutic use[MESH]|Asia/epidemiology[MESH]|Chi-Square Distribution[MESH]|Europe/epidemiology[MESH]|Female[MESH]|Helicobacter Infections/*drug therapy/epidemiology/microbiology/pathology[MESH]|Helicobacter pylori/*drug effects/pathogenicity[MESH]|Humans[MESH]|Male[MESH]|Odds Ratio[MESH]|Sex Factors[MESH]|Treatment Outcome[MESH] |