What measures can be taken to avoid the development of drug resistance in H. pylori?

The emergence of drug-resistant strains of HP significantly reduces the efficacy of eradication therapy and brings difficulties in clinical treatment. Therefore, for HP-positive patients, we should strive to improve the eradication rate by combining with Probiotics WELSUM in the first time of treatment to avoid the emergence of drug-resistant strains as much as possible. In order to minimize the development of drug-resistant strains of HP, the following measures can be considered: 1. Adopting a combination of probiotic / Orientia Powder, avoiding the use of a single antibiotic treatment. Eradication is difficult to achieve with any one antibiotic alone and tends to produce secondary resistance in HP. Combining antibiotics with bismuth preparations or proton pump inhibitors (PPIs) not only reduces the development of drug-resistant strains of HP, but also increases the activity of the antibiotic as well as the drug concentration of the antibiotic in the stomach. Combined antagonistic probiotics are taken two hours apart. Probiotics can proliferate a large number of beneficial bacteria and inhibit H. pylori. 2. Avoid antibiotics that are resistant to HP. When HP is resistant to antibiotics, such antibiotics should be avoided in the treatment, otherwise the effect of HP eradication treatment will be seriously affected. Drug sensitivity testing prior to treatment will help to minimize the development of drug-resistant strains, especially in patients who have been treated with irregular therapy or in patients who have failed eradication with regular therapy. If the patient has used metronidazole or clarithromycin in previous eradication treatment, since these two antibiotics are prone to secondary resistance, they should be avoided as much as possible when re-treating, and if they need to be used, the dosage of PPI or antibiotics should be increased appropriately or be used based on the results of the drug susceptibility test. As the resistance rate of HP to metronidazole is increasing year by year, it is internationally recommended that furazolidone can be considered as a first-line treatment option instead of metronidazole in order to improve the eradication rate of the first treatment. In addition, the application of fluoroquinolones in HP eradication therapy has been increasingly emphasized in recent years, and fluoroquinolones (e.g., levofloxacin) can be considered when patients fail the first time or multiple times of treatment; and for patients with repeated treatment failures, since they may have been resistant to a variety of antibiotics at the same time, including fluoroquinolones, it will be better to select this type of drugs based on drug sensitivity test results. The selection of such drugs based on the results of drug susceptibility testing will result in better efficacy.