Lack of Usefulness of Literature‐Based Helicobacter pylori Resistance Data for Predicting First‐Line Empirical Treatment Effectiveness in the European Registry on H. pylori Management (Hp‐EuReg)

@article{kirrout2026lack,
  title = {{Lack of Usefulness of Literature‐Based Helicobacter pylori Resistance Data for Predicting First‐Line Empirical Treatment Effectiveness in the European Registry on H. pylori Management (Hp‐EuReg)}},
  author = {Ismail Kirrout and Olga P. Nyssen and Ángeles Pérez‐Aísa and Bojan Tepes and Irina N. Voynovan and Samuel J. Martínez‐Domínguez and Alfredo J. Lucendo and Ludmila G. Vologzanina and Matteo Pavoni and Sayar R. Abdulkhakov and Maja Denkovski and Javier Tejedor‐Tejada and Tatiana Ilchishina and Luis Bujanda and Aiman S. Sarsenbaeva and Jose M. Huguet and Oleg Zaytsev and Boris D. Starostin and Monica Perona and Antonietta G. Gravina and Manuel Pabón‐Carrasco and Sergey A. Alekseenko and Óscar Núñez and Miguel Areia and Jesús Barrio and Antonio Moreno Loro and Dmitry N. Andreev and Blas José Gómez Rodríguez and María Soledad Marcos and Inmaculada Ortiz‐Polo and Galina N. Tarasova and Igor Bakulin and Mónica Sánchez Alonso and Irene Arteagoitia and Virginia Flores and Manuel Jiménez‐Moreno and Dmitry S. Bordin and Antonio Gasbarrini and Ricardo Marcos‐Pinto and Wojciech Marlicz and Perminder S. Phull and Marino Venerito and Doron Boltin and Lyudmila Boyanova and Pablo Parra and Leticia Moreira and Francis Mégraud and Colm O'Morain and Nuria Montes and Javier P. Gisbert and Natalia N. Dekhnich and Natalia N. Dekhnich and Pilar Mata‐Romero and Natalia Valerievna Bakulina and Alla G. Kononova and Giuseppe Losurdo and Judith Gomez‐Camarero and Alma Keco‐Huerga and Pablo M. Wolfe García and Jurij Bednarik},
  journal = {Helicobacter},
  year = {2026},
  month = nov,
  doi = {10.1111/hel.70169},
  url = {https://doi.org/10.1111/hel.70169},
  note = {CC BY 4.0},
}

TY  - JOUR
TI  - Lack of Usefulness of Literature‐Based Helicobacter pylori Resistance Data for Predicting First‐Line Empirical Treatment Effectiveness in the European Registry on H. pylori Management (Hp‐EuReg)
AU  - Ismail Kirrout
AU  - Olga P. Nyssen
AU  - Ángeles Pérez‐Aísa
AU  - Bojan Tepes
AU  - Irina N. Voynovan
AU  - Samuel J. Martínez‐Domínguez
AU  - Alfredo J. Lucendo
AU  - Ludmila G. Vologzanina
AU  - Matteo Pavoni
AU  - Sayar R. Abdulkhakov
AU  - Maja Denkovski
AU  - Javier Tejedor‐Tejada
AU  - Tatiana Ilchishina
AU  - Luis Bujanda
AU  - Aiman S. Sarsenbaeva
AU  - Jose M. Huguet
AU  - Oleg Zaytsev
AU  - Boris D. Starostin
AU  - Monica Perona
AU  - Antonietta G. Gravina
AU  - Manuel Pabón‐Carrasco
AU  - Sergey A. Alekseenko
AU  - Óscar Núñez
AU  - Miguel Areia
AU  - Jesús Barrio
AU  - Antonio Moreno Loro
AU  - Dmitry N. Andreev
AU  - Blas José Gómez Rodríguez
AU  - María Soledad Marcos
AU  - Inmaculada Ortiz‐Polo
AU  - Galina N. Tarasova
AU  - Igor Bakulin
AU  - Mónica Sánchez Alonso
AU  - Irene Arteagoitia
AU  - Virginia Flores
AU  - Manuel Jiménez‐Moreno
AU  - Dmitry S. Bordin
AU  - Antonio Gasbarrini
AU  - Ricardo Marcos‐Pinto
AU  - Wojciech Marlicz
AU  - Perminder S. Phull
AU  - Marino Venerito
AU  - Doron Boltin
AU  - Lyudmila Boyanova
AU  - Pablo Parra
AU  - Leticia Moreira
AU  - Francis Mégraud
AU  - Colm O'Morain
AU  - Nuria Montes
AU  - Javier P. Gisbert
AU  - Natalia N. Dekhnich
AU  - Natalia N. Dekhnich
AU  - Pilar Mata‐Romero
AU  - Natalia Valerievna Bakulina
AU  - Alla G. Kononova
AU  - Giuseppe Losurdo
AU  - Judith Gomez‐Camarero
AU  - Alma Keco‐Huerga
AU  - Pablo M. Wolfe García
AU  - Jurij Bednarik
PY  - 2026
DA  - 2026/11/05
JO  - Helicobacter
DO  - 10.1111/hel.70169
UR  - https://doi.org/10.1111/hel.70169
AB  - Background:  Helicobacter pylori ( H. pylori ) infection causes gastritis, peptic ulcer disease, and gastric cancer. Without an effective vaccine, eradication therapy remains crucial. However, increasing antibiotic resistance compromises treatment effectiveness.  Objective: To evaluate whether literature‐based resistance data could predict first‐line empirical treatment effectiveness.  Methods: Resistance rates for clarithromycin, metronidazole, and levofloxacin were extracted from bibliographic reviews and estimated for three timeframes: the treatment year, the preceding year, and the last five years average. These rates (2008–2024) were matched with outcomes from the European Registry on H. pylori Management (Hp‐EuReg, WorldHpReg partner), a prospective real‐world study involving 40 countries. Analyses included Spearman's correlations, multivariate logistic regressions adjusted for demographic, clinical, and therapeutic‐related variables, bootstrap resampling stratified by eradication success, and Random Forest models.  Results: Analysis included 37,659 patients receiving first‐line empirical treatment from 13 countries. Moderate negative correlations were observed between metronidazole and clarithromycin resistances for some regimens. In the regression model, including either contemporaneous or previous‐year resistance rates, clarithromycin resistance showed a negligible positive association, while metronidazole resistance was negatively associated. In regimen‐specific models, previous‐year clarithromycin resistance was positively associated with success in concomitant therapy, whereas higher five‐year mean clarithromycin resistance reduced eradication odds in quadruple clarithromycin–amoxicillin–bismuth therapy. Random Forest models identified compliance, proton‐pump inhibitor dose, regimen duration, and treatment as the strongest predictors of eradication, while resistance variables contributed minimally.  Conclusion: Literature‐based resistance data are not useful for guiding real‐world first‐line H. pylori therapy, highlighting the need for individualized antibiotic susceptibility testing to obtain reliable resistance information.  Trial Registration: ClinicalTrials.gov identifier: NCT02328131
SN  - 1083-4389
SN  - 1523-5378
ER  -