Docteur André GIBERT - Hépato- Gastro- Entérologie
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Résistance d'Helicobacter pylori aux antibiotiques

La résistance aux antibiotiques d'Hélicobacter pylori est de plus en plus fréquente dans le monde. En Chine la résistance au métronidazole est passée de 66,8 à 63,4%, de 39,9 à 52,6% pour la clarithromycine, de 34,5 à 54,8% pour la lévofloxacine, de 15,4 à 18,2 % pour la rifampicine, de 6,7 à 4,4% pour l'amoxicilline et de 4,9 à 7,3% pour les tétracyclines. Une augmentation très significative des résistances à la clarithromycine et à la lévofloxacine a été observée.   Le sexe était un facteur de risque indépendant de résistance ainsi que l'âge et les constatations endoscopique. Helicobacter pylori a développé des résistances partout dans le monde ce qui qui rend difficile l'utilisation des antibiotiques en premières lignes d'éradication ou des traitements séquentiels. L'utilisation des traitements à base de bismuth devrait permettre de limiter les échecs ainsi que le test de la sensibilité de la bactérie aux antibiotiques.
(Zhang YX et al. World J Gastroenterol. 2015 Mar 7; 21(9): 2786-92

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