Emerging of Antibiotic Resistance of Helicobacter pylori among Hospitalized Patients: A Systematic Review

Abstract

Introduction: The deficiency in information regarding anti biotic susceptibility and H.pylori resistance in children group is considered a massive problem. Additionally, the majority of the studies contain small sample size putting their effort on adult patients. This review aiming at collecting comprehensive information regarding antibiotic resistance of H.pylori in children, to increase the awareness about this important population group.
Methods: The systematic review was conducted with specific inclusion and exclusion criteria in mind. Inclusion criteria involved studies published in the English language, focused on antibiotic susceptibility or resistance in Helicobacter pylori (H. pylori) infections among children aged 0-18 years, and encompassed various study designs such as observational studies. A robust and comprehensive search strategy was formulated to identify relevant studies in five major electronic databases: PubMed/MEDLINE, Embase, Scopus, Web of Science, and the Cochrane Library. The search strategy incorporated combinations of keywords related to "H. pylori," "antibiotic resistance," "children," and "pediatric population." Boolean operators were utilized to refine and optimize search results.
Results: The search of the literature, after exclusion of irrelevant, duplicated and review studies, revealed 11 studies met the inclusion criteria. Included studies aimed to determine, from the best available evidence from different cohort studies that pointed out to the epidemiology of antibiotics resistance only towards Helicobacter pylori pathogen.
Conclusions: The findings underscore the substantial variability in resistance rates among different antibiotics, with metronidazole and clarithromycin exhibiting particularly high resistance levels in certain studies. Moreover, the wide age range and the diverse clinical presentations of H. pylori infection in children were notable, highlighting the complexity of diagnosingand managing this condition in this population. The evidence presented here emphasizes the urgent need for continued research and surveillance on antibiotic resistance in pediatric H. pylori infections, particularly in the context of evolving resistance patterns and varying clinical presentations.