{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T00:15:26Z","timestamp":1791504926223,"version":"4.3.4"},"reference-count":45,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2024,2,28]],"date-time":"2024-02-28T00:00:00Z","timestamp":1709078400000},"content-version":"vor","delay-in-days":58,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Helicobacter"],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p><jats:italic>Helicobacter pylori<\/jats:italic> antibiotic resistance has undergone vast changes in the last two decades. No systematic review has been done on the prevalence of antibiotic resistant <jats:italic>H. pylori<\/jats:italic> in India in the last two decades. We evaluated the pattern of resistance rates across various regions of India.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and Methods<\/jats:title><jats:p>A systematic review of the geographical variations in antibiotic resistance pattern of <jats:italic>H. pylori<\/jats:italic> was conducted using PubMed, Google Scholar, Web of Science, Science Direct, etc. for articles published between January 1, 2000 and May 30, 2023. Random effects\u2010model\u2010based Cochran's Q test, <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup> statistics, and chi\u2010squared tests were used to measure heterogeneity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The overall resistance was highest against metronidazole (77.65%) followed by amoxicillin (37.78%), levofloxacin (32.8%), clarithromycin (35.64%), furazolidone (12.03%), and tetracycline (11.63%). 14.7% of the <jats:italic>H. pylori<\/jats:italic> isolates were multi\u2010drug resistant. Under meta\u2010analysis of each antibiotic, high heterogeneity levels were observed having <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup> ranges from 86.53% to 97.70% at <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001. In sub\u2010group analysis, Metronidazole has a stable rate of resistance as compared to other antibiotics. Other antibiotics have had a downtrend in the last 5\u2009years except for levofloxacin, which has had an uptrend in the resistance rate for the past 5\u2009years. Hence, one should avoid using metronidazole for any kind of first\u2010line treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Metronidazole resistance is high in most regions of India except Assam and Mumbai while clarithromycin is found to be ineffective in South India, Gujarat, and Kashmir. As compared to other antibiotics, resistance to amoxicillin is generally low except in certain regions (Hyderabad, Chennai, and the Gangetic belt of North India). Tetracycline and Furazolidone have the least resistance rates and should be part of anti\u2010 <jats:italic>H. pylori<\/jats:italic> regimens. The resurgence of high single and multidrug resistance to the commonly used drugs suggests the need for newer antibiotics and regular resistance surveillance studies.<\/jats:p><\/jats:sec>","DOI":"10.1111\/hel.13057","type":"journal-article","created":{"date-parts":[[2024,2,28]],"date-time":"2024-02-28T11:45:02Z","timestamp":1709120702000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":25,"title":["Primary antibiotic resistance of <i>Helicobacter pylori<\/i> in India over the past two decades: A systematic review"],"prefix":"10.1111","volume":"29","author":[{"given":"Spriha","family":"Dutta","sequence":"first","affiliation":[{"name":"Centre for Medical Biotechnology, Amity Institute of Biotechnology Amity University  Noida Uttar Pradesh India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Surbhi","family":"Jain","sequence":"additional","affiliation":[{"name":"Centre for Medical Biotechnology, Amity Institute of Biotechnology Amity University  Noida Uttar Pradesh India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kunal","family":"Das","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Yashoda Superspeciality Hospital  Kausambi, Ghaziabad Uttar Pradesh India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Prashant","family":"Verma","sequence":"additional","affiliation":[{"name":"Department of Statistics University of Allahabad  Prayagraj Uttar Pradesh India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anup","family":"Som","sequence":"additional","affiliation":[{"name":"Centre of Bioinformatics, Institute of Interdisciplinary Studies University of Allahabad  Prayagraj Uttar Pradesh India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rajashree","family":"Das","sequence":"additional","affiliation":[{"name":"Centre for Medical Biotechnology, Amity Institute of Biotechnology Amity University  Noida Uttar Pradesh India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,2,28]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2036.2005.02533.x"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jgar.2016.02.007"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jgar.2015.09.009"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12664-021-01186-4"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/qco.0000000000000396"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/hel.12531"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmi.2017.11.010"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2016-312288"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2016.563"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2016.04.006"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/0197-2456(86)90046-2"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10844-006-2974-4"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.22159\/ajpcr.2018.v11i8.25220"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.4236\/aim.2012.23031"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13099-019-0305-x"},{"issue":"4","key":"e_1_2_11_17_1","first-page":"549","article-title":"Helicobacter pylori infection in India from a western perspective","volume":"136","author":"Thirumurthi S","year":"2012","journal-title":"Indian J Med Sci"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijmmb.2022.02.008"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1440-1746.2003.03276.x"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.3855\/jidc.60"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0255-0857(21)03252-7"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.18231\/j.ijmr.2019.063"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.4103\/0255-0857.142256"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00284-006-0143-1"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.14260\/jemds\/2015\/1566"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.4103\/ijmm.ijmm_18_19"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1440-1746.2003.03174.x"},{"key":"e_1_2_11_28_1","unstructured":"GehlotV MahantS DasK DasR.Most of theHelicobacter pyloriisolates are resistant to levofloxacin in north IndiaShort Communication.2016http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"key":"e_1_2_11_29_1","doi-asserted-by":"publisher","DOI":"10.4103\/ijmr.ijmr_1356_15"},{"key":"e_1_2_11_30_1","doi-asserted-by":"publisher","DOI":"10.1002\/9781119536604.ch10"},{"key":"e_1_2_11_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/B978-0-12-411643-6.00031-4"},{"key":"e_1_2_11_32_1","doi-asserted-by":"publisher","DOI":"10.1136\/gut.2006.101634"},{"key":"e_1_2_11_33_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140"},{"key":"e_1_2_11_34_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2018.10.012"},{"key":"e_1_2_11_35_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12664-019-00949-4"},{"key":"e_1_2_11_36_1","doi-asserted-by":"publisher","DOI":"10.1097\/00042737-199409000-00004"},{"key":"e_1_2_11_37_1","doi-asserted-by":"publisher","DOI":"10.1155\/2014\/483136"},{"key":"e_1_2_11_38_1","doi-asserted-by":"publisher","DOI":"10.1111\/apt.13497"},{"key":"e_1_2_11_39_1","doi-asserted-by":"publisher","DOI":"10.1016\/s1473-3099(14)70780-7"},{"key":"e_1_2_11_40_1","doi-asserted-by":"publisher","DOI":"10.1016\/s2468-1253(17)30219-4"},{"key":"e_1_2_11_41_1","doi-asserted-by":"publisher","DOI":"10.1155\/2020\/2304173"},{"key":"e_1_2_11_42_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13756-019-0632-1"},{"key":"e_1_2_11_43_1","doi-asserted-by":"publisher","DOI":"10.1128\/jb.182.11.3219-3227.2000"},{"key":"e_1_2_11_44_1","doi-asserted-by":"publisher","DOI":"10.31783\/elsr.2022.810521"},{"key":"e_1_2_11_45_1","doi-asserted-by":"publisher","DOI":"10.4236\/aim.2012.23031"},{"key":"e_1_2_11_46_1","doi-asserted-by":"publisher","DOI":"10.4103\/0255-0857.167349"}],"container-title":["Helicobacter"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/hel.13057","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,26]],"date-time":"2025-04-26T04:43:00Z","timestamp":1745642580000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/hel.13057"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,1]]},"references-count":45,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2024,1]]}},"alternative-id":["10.1111\/hel.13057"],"URL":"https:\/\/doi.org\/10.1111\/hel.13057","archive":["Portico"],"relation":{},"ISSN":["1083-4389","1523-5378"],"issn-type":[{"value":"1083-4389","type":"print"},{"value":"1523-5378","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,1]]},"assertion":[{"value":"2023-09-16","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-02-06","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-02-28","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e13057"}}