Helicobacter pylori in Iran: A systematic review on the antibiotic resistance

Abstract

<em>Objective(s):</em><em>Helicobacter pylori</em> (<em>H. pylori</em>) is a pathogenic bacterium that colonizes the stomachs of approximately 50% of the world's population. Resistance of <em>H. pylori</em> to antibiotics is considered as the main reason for the failure to eradicate this bacterium. The aim of this study was to determine the rate of resistant <em>H. pylori </em>strains to various antimicrobial agents in different areas of Iran. <br/><em>Materials and Methods:</em> A systematic review of literatures on <em>H. pylori</em> antibiotic resistance in Iran was performed within the time span of 1997 to 2013. Data obtained from various studies were tabulated as following, 1) year of research and number strains tested, 2) number of <em>H. pylori</em> positive patients, 3) study place, 4) resistance of <em>H. pylori </em>to various antibiotics as percentage, and 5) methods used for evaluation of antibiotic resistance. <br/><em>Results:</em> Over the period, a total of 21 studies on<em> H. pylori </em>antibiotic resistance have been conducted in different parts of Iran. In these studies, <em>H. pylori</em> resistance to various antibiotics, including metronidazole, clarithromycin, amoxicillin, tetracycline, ciprofloxacin, levofloxacin and furazolidone were 61.6%, 22.4% ,16.0%, 12.2%, 21.0%, 5.3% and 21.6%, respectively. We found no study on <em>H. pylori</em> resistance to rifabutin in Iran. <br/><em>Conclusion:</em> Compared to the global average, we noted that the prevalence of <em>H. pylori</em> resistance to metronidazole, clarithromycin, amoxicillin, and tetracycline has been rapidly growing in Iran. This study showed that in order to determine an appropriate drug regimen against <em>H. pylori</em>, information on antibiotic susceptibility of the bacterium within different geographical areas of Iran is required.