Across much of Europe, resistance to antibiotics used to treat bacterial infections associated with common stomach conditions has more than doubled in the last two decades, according to new research.
Preliminary findings presented at United European Gastroenterology Week Barcelona 2019 suggest that resistance to antibiotics commonly taken for Helicobacter pylori infection, a bacterium that is associated with gastric ulcer, lymphoma, and gastric cancer, is increasing in recent years. In a survey of more than 1,200 people from 18 European countries, researchers found that resistance to clarithromycin, antimicrobials used to commonly treat H. pylori, had increased from 9.9 percent in 1998 to 21.6 percent last year. Similar rises in resistance have been seen in levofloxacin and metronidazole.
Antibiotic resistance occurs when a bacterium begins to develop a tolerance to the pharmaceutical drugs targeted to treat it. In recent years, antibiotic resistance has become an increasing issue around the world and has garnered attention from global leaders like the World Health Organization (WHO) calling for strategic efforts to combat the “global health security threat.” In the EU and US alone, at least 56,000 people die annually as a direct result of infection from antibiotic-resistant bacteria.
- Infections from H. pylori are “complex” to treat and require a combination of medications. The bacterium typically infects the stomach of children and causes inflammation of the stomach lining, or gastritis, resulting in peptic ulcers. It’s likely that more than half of the world’s population is infected with the bacterium but will not get sick from it until ulcers develop, according to the Mayo Clinic.
“With resistance rates to commonly used antibiotics such as clarithromycin increasing at an alarming rate of nearly 1% per year, treatment options for H. pylori will become progressively limited and ineffective if novel treatment strategies remain undeveloped,” said lead researcher Francis Megraud in a statement. “The reduced efficacy of current therapies could maintain the high incidence rates of gastric cancer and other conditions such as peptic ulcer disease if drug resistance continues to increase at this pace."
H. pylori has also been identified as a risk factor for gastric cancer and has been deemed as the third leading cause of cancer death across the world. The study found that the highest rates of H. pylori resistance to clarithromycin were in Southern Italy (39.9 percent), Croatia (34.6 percent), and Greece (30 percent). According to the researchers, these high levels are largely attributed to the overuse of antibiotics for common ailments like the cold and flu.
"The findings of this study are certainly concerning, as H. pylori is the main cause of peptic disease and gastric cancer," said Mário Dinis-Ribeiro, President of the European Society of Gastrointestinal Endoscopy. "The increasing resistance of H. pylori to a number of commonly-used antibiotics may jeopardize prevention strategies."