Antibiotic Resistance of
                    <i>Helicobacter pylori</i>
                    in Eastern China: An Updated Multicenter Cross‐Sectional Surveillance Study From 2022 to 2025

doi:10.1111/hel.70170

DOI: 10.1111/hel.70170 ISSN: 1083-4389

Antibiotic Resistance of Helicobacter pylori in Eastern China: An Updated Multicenter Cross‐Sectional Surveillance Study From 2022 to 2025

Shihan Xu, Yifan Qiu, Jiayue Wang, Chanjuan Wang, Xianzhu Zhou, Huiyun Zhu, Wenbo Zhu, Pei Xie, Liting Shen, Huabing Huang, Xintong Zhao, Hengjun Gao, Zhaoshen Li, Yiqi Du

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ABSTRACT

Background

Rising Helicobacter pylori antibiotic resistance compromises efficacy of empirical eradication therapies. This study aimed to provide updated, region‐specific resistance data in Eastern China to guide empirical treatment strategies.

Methods

A multicenter, cross‐sectional study was conducted across 30 institutions in Eastern China from 2022 to 2025. Susceptibility to six antibiotics was evaluated using the Kirby‐Bauer disk diffusion method.

Results

A total of 1088 H. pylori isolates from gastric biopsies were analyzed. Resistance rates were exceptionally high for metronidazole (93.8%), clarithromycin (71.0%), and levofloxacin (61.2%), whereas resistance to amoxicillin, furazolidone, and tetracycline remained universally low (< 1%). Multidrug resistance (MDR) was highly prevalent at 80.0%. However, resistance to metronidazole, levofloxacin, and clarithromycin showed decreasing trends over the study period.

Interpretation

Given the alarming resistance levels, empirical use of clarithromycin‐ and levofloxacin‐based regimens should be approached with caution in Eastern China. Where universal susceptibility testing is not accessible, there is an urgent need to explore and validate novel, effective empirical eradication regimens and to establish sustained regional resistance surveillance networks to dynamically refine H. pylori management strategies.