Helicobacter Pylori Resistance Mechanisms And Sequential Therapy Research

Background: Helicobacter pylori (Helicobacter pylori, H.pylori) is a kind ofmicroaerophilic G-Bacillus. The bacteria was found by Marshall and Warren on thegastric mucosal surface below the mucus layer in1982.Extensive researches andclinical practices confirmed that H.pylori was closely related to peptic ulcer, atrophicgastritis, gastric cancer and other diseases of the digestive system. The standard tripletherapy to eradicate H.pylori that was composed of a proton pump inhibitor (protonpump inhibitors PPI), clarithromycin, amoxicillin or metronidazole was taken allover the world nowadays. As it was used in the clinical for a long time and the wideuse of antibiotics, large number of resistant strains have emerged, the eradication ofH.pylori becomes more and more difficult. It was reported that the eradication rate ofthe standard triple therapy has dropped to66.6%, so it is particularly important andurgent to explore the mechanisms of resistance and to search more effectiveeradication plans. At present, it was shown that the eradication rate of the sequentialtherapy is more than90%by a number of clinical trials, and it is an efficienteradication program. This paper intends to made a summary about the resistancemechanisms and the research progress of the sequential therapy and expected tocontribute to provide a reference for clinical treatment.Objective: To provide references for the clinical therapeutics, the resistancemechanism of H.pylori and sequential therapy research of H.pylori were reviewed inthe paper.Methods: To summarize the resistance mechanisms and the treatment progression ofH.pylori, the literatures in recent years relating to H.pylori in Wanfang,Weipu andPubmed database have been researched. Results: H.pylori resistance is mainly related to its gene mutation. The latest H.pylorieradication program-sequential therapy with fewer adverse reactions, good patientscompliance, higher eradication rate and so on had been confirmed in the clinicaltrials.Conclusion: The different molecular basis of H.pylori antibiotic resistance remains tobe further studied; the latest treatments-sequential therapy is a highly effectiveeradication program, and has broad prospects for treatment.