The management of Helicobacter pylori infection in the post-Covid-19 era

The COVID-19 pandemic has undoubtedly reshaped many aspects of healthcare, but one of its most concerning impacts hasbeen on antibiotic use and the growing crisis of antibiotic resistance, particularly in relation to Helicobacter pylori (H. pylori)infections. In Croatia, as in many other parts of the world, the pandemic led to significant shifts in antibiotic prescription practices.This was driven by early, and often unproven, claims of the effectiveness of certain antibiotics in treating COVID-19, along withshortages of commonly used medications like penicillin. These factors resulted in a marked increase in the use of macrolides, suchas azithromycin, which has been linked to worsening antibiotic resistance in H. pylori. In Croatia, antibiotic use in 2022 surpassed2019 levels, driven by increased consumption of macrolides and other antibiotics. However, as resistance to these drugs rises,the effectiveness of these regimens diminishes. To address these challenges, healthcare providers must adopt more personalizedapproaches to treating H. pylori infections. One potential solution is the use of tailored antibiotic therapy, based on local resistancepatterns or individual susceptibility testing.