{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T15:45:33Z","timestamp":1787067933388,"version":"build-2736575974"},"reference-count":15,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2025,12,30]],"date-time":"2025-12-30T00:00:00Z","timestamp":1767052800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,12,30]],"date-time":"2025-12-30T00:00:00Z","timestamp":1767052800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Gastro and Hepatol"],"published-print":{"date-parts":[[2026,2]]},"abstract":"ABSTRACT<\/jats:title>\n \n \n Helicobacter pylori<\/jats:italic>\n <\/jats:styled-content>\n infection remains globally prevalent and is a major cause of chronic gastritis, peptic ulcer disease, and gastric cancer (GC). The Asia\u2010Pacific region has the highest global burden of infection and GC mortality; however, the effectiveness of eradication therapy is increasingly being compromised by antibiotic resistance. Between 1990 and 2022, resistance to clarithromycin (CAM), metronidazole (MNZ), and levofloxacin (LVX) increased markedly from 7%, 37%, and 9% to 30%, 61%, and 35%, respectively, whereas resistance to amoxicillin and tetracycline remained low at approximately 4%. Multidrug\u2010resistant\n \n H. pylori<\/jats:italic>\n <\/jats:styled-content>\n strains are increasingly being reported in Southeast Asia. The resistance rates among the pediatric and adolescent population in East Asia are similarly high, 37% for CAM, 51% for MNZ, and 19% for LVX, suggesting intrafamilial transmission. The key molecular mechanisms include genetic mutations in 23S rRNA,\n rdxA<\/jats:italic>\n \/\n frxA<\/jats:italic>\n , and\n gyrA<\/jats:italic>\n \/\n gyrB<\/jats:italic>\n , along with adaptive traits such as efflux pump activation and biofilm formation, and coccoid transformation. East Asian countries have adopted divergent strategies, including vonoprazan\u2010based triple therapy in Japan, bismuth\u2010containing quadruple therapy as the preferred first\u2010line regimen in Taiwan, Hong Kong, and China, and tailored regimens based on susceptibility testing in Korea. Future directions include susceptibility\u2010guided therapy, molecular diagnostic testing, family\u2010based eradication, and the development of nonantibiotic therapies. Establishing regional resistance surveillance networks and integrating\n \n H. pylori<\/jats:italic>\n <\/jats:styled-content>\n management into national antimicrobial stewardship programs are essential to maintain eradication success and prevent GC. Addressing antibiotic resistance in\n \n H. pylori<\/jats:italic>\n <\/jats:styled-content>\n is an urgent public health priority, and coordinated regional strategies are required in the Asia\u2010Pacific region.\n <\/jats:p>","DOI":"10.1111\/jgh.70227","type":"journal-article","created":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T06:36:07Z","timestamp":1767162967000},"page":"387-391","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Antibiotic Resistance in\n \n Helicobacter pylori<\/i>\n <\/scp>\n in the Asia\u2010Pacific Region: A Call for Coordinated Regional Strategies"],"prefix":"10.1111","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9075-6415","authenticated-orcid":false,"given":"Koji","family":"Otani","sequence":"first","affiliation":[{"name":"Department of Gastroenterology Osaka Metropolitan University Graduate School of Medicine Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wan\u00a0Ying","family":"Lai","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology Prince of Wales Hospital Shatin Hong Kong"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jyh\u2010Ming","family":"Liou","sequence":"additional","affiliation":[{"name":"Department of Medicine National Taiwan University Cancer Center Taipei Taiwan"},{"name":"Department of Internal Medicine National Taiwan University Hospital Taipei Taiwan"},{"name":"College of Medicine National Taiwan University Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasuhiro","family":"Fujiwara","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Osaka Metropolitan University Graduate School of Medicine Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,12,30]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.2147\/IDR.S250200"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2025-335523"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2468-1253(17)30219-4"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2468-1253(23)00281-9"},{"key":"e_1_2_12_6_1","first-page":"10","article-title":"The Emergence of Multidrug\u2010Resistant Helicobacter Pylori in Southeast Asia: A Systematic Review on the Trends and Intervention Strategies Using Antimicrobial Peptides","volume":"10","author":"Sukri A.","year":"2021","journal-title":"Antibiotics (Basel)"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/CM9.0000000000002884"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v31.i10.102289"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13099-025-00704-5"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/hel.12368"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2025-336027"},{"key":"e_1_2_12_12_1","first-page":"532","article-title":"Consensus Recommendations for the Screening, Diagnosis, and Management of Helicobacter Pylori Infection in Hong Kong","volume":"29","author":"Leung W. K.","year":"2023","journal-title":"Hong Kong Medical Journal"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/hel.12475"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/CM9.0000000000002546"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.5009\/gnl20288"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgh.16862"}],"container-title":["Journal of Gastroenterology and Hepatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jgh.70227","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/jgh.70227","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jgh.70227","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T19:08:36Z","timestamp":1781809716000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jgh.70227"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,30]]},"references-count":15,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026,2]]}},"alternative-id":["10.1111\/jgh.70227"],"URL":"https:\/\/doi.org\/10.1111\/jgh.70227","archive":["Portico"],"relation":{},"ISSN":["0815-9319","1440-1746"],"issn-type":[{"value":"0815-9319","type":"print"},{"value":"1440-1746","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,30]]},"assertion":[{"value":"2025-10-29","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-12-20","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-12-30","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}