Hamed Ebrahimzadeh Leylabadlo - Students’ Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
Reza Ghotaslou - Department of Bacteriology and Virology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
Narges Darabi - Microbiology Department, Faculty of Medicine, Semnan University of Medical Sciences, Semnan, Iran
Mohammad Ahangarzadeh Rezaee - Infectious and Tropical Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.

Background: Helicobacter pylori infection occurs when a type of bacteria called H. pylori infects stomach and affecting almost half the world population. Resistance of H. pylori to antibiotics especially clarithromycin and metronidazole is considered as the main reason for the failure to eradicate. The aim of this study was to determine the resistance rate of H. pylori to clarithromycin and metronidazole in different countries in Asia. Methods: A systematic review of literatures carried out on H. pylori resistance to clarithromycin and metronidazole in Asia through PubMed published in English language from 2011 until 2016. Results: Among the 43 studies in different countries in Asia, the average resistance rate of H. pylori to clarithromycin and metronidazole were 35.54% and 56.38%, respectively. The highest and the least H. pylori resistance to clarithromycin were 52.8% in China and 2.44% in Malaysia, also the highest and the least H. pylori resistance to metronidazole were 83.8% in India and 22.15% in Taiwan, respectively. Conclusion: The prevalence of metronidazole resistance was at a high level in the Asian patients. We noted that the prevalence of H. pylori resistance to clarithromycin and metronidazole has been rapidly increasing in Asia. Resistance to antimicrobial agents is worldwide problem and need a good strategy for fight against growing spread antibiotic resistance.

Helicobacter pylori, Clarithromycin, Metronidazole, Resistance, Asia