Helicobacter pylori: a systematic review of drug resistance in Iran

Abstract

AIM: Helicobacter pylori (H. pylori) is one of the most common causes of gastrointestinal diseases, including gastric infections in humans. It is estimated that the annual incidence of H. pylori infection in developing countries is 4–15%. Approximately 50% of people worldwide are infected with this bacterium. The purpose of this study is to review recent studies on antibiotic resistance of H. pylori in Iran. Methods: A complete search was performed using SID, PubMed, MEDLINE, Science Direct, Cochrane Library, EMBASE, Google Scholar, and Scopus databases to access various articles for these studies. In this study, articles published from 2005 to 2020 were selected. Previously published specialized articles and systematic meta-analysis were used as a supplementary source for identifying relevant articles. Finally, data from 34 articles were pooled and analyzed. Results: In this study, the resistance of H. pylori to metronidazole, ciprofloxacin, furazolidone, rifamycin, clarithromycin, amoxicillin, and tetracycline antibacterial agents was evaluated in about 34 studies over 15 years. The mean resistance to metronidazole is about 64.10%, rifamycin 27.78%, furazolidone 24.33%, ciprofloxacin 22.51%, clarithromycin 22.50%, amoxicillin 18.37, and tetracycline 14.89%. Conclusion: H. pylori drug resistance has increased throughout Iran against the studied antibiotics. The present study shows alarming results and a new program is needed to eradicate H. pylori infections.