There are many infections that are resistant to antibiotics This is also true of the Helicobacter pylori infection. H pylori has been implicated in the cause of peptic ulcers, gastric ( stomach ) cancer and even heart disease. Helicobacter pylori (HP) is increasingly drug resistant. There are failure rates of 5-10% even after two different antimicrobial antibiotics. Failure due to resistance to clarithromycin may be as high as 30 % and some are resistant to levofloxacin. There are even studies that we should eradicate all of the HPO as there may be a protection for the gut microbiome.
In high socioeconomic groups the rate of HP is thankfully decreasing There are other barriers which is the type of testing and timing of the testing. Test for active infection should include stool antigen and or breath testing. Both of these are sensitive and specific , 95 % for each respectively. Both of these tests MUST be performed more than four weeks after the use of either a bismuth product, and or an antibiotic. All of the PPI drugs must be stopped for more than 2 weeks.
To help resistance the patients should strictly adhere to regimen 1 feel that most patients cannot complete the protocol. I have used berberine containing herbs to treat HP effectively.
The other treatment modality is Mastica ( also called Mastic gum) which is the resin from a tree that grows on an island belonging to Greece. This is very effective in eradicating HP. I also use and employ gastrointestinal teas as Slippery Elm, Marsh mallow, and Meadowsweet