Acquisition of the drug resistance and Helicobacter pylori gene mutation

: The currently recommended regimen in Japan is a proton pump inhibitor-based triple therapy with two of the antibiotics between clarithromycin, amoxicillin and metronidazole. However, recent years have witnessed a decrease in the rate of eradication due to antimicrobial resistance. Resistance mechanisms of H. pylori are explained by the occurrence of mutations in genomic genes, which may correspond to the 23S rRNA gene in clarithromycin, the pbp1A in amoxicillin, and the rdxA in metronidazole, gyrA in levofloxacin. The resistance of H. pylori strains to clarithromycin is currently estimated at about 30% in Japan, while the resistant rates to metoronidazole and amoxicillin are quite low. The resistant rates of each antibiotics may increase in future, so we need to observe those changes.