Helicobacter Forums

I was under the impression that H Pylori can never become resistant to Amoxicillin. But I recently came across an article that claimed nearly 8% resistance among the test subjects. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6513510/)

Is the study accurate? What is the reason for H Pylori to be unable to be resistant to Amoxicillin?

It's a bit awkward. because it is our group that publish this paper. It's a collaboration between our group and the Indian group. We helped them with the genome sequencing while they provide the antibiotic resistant profile. It is almost unbelievable to see such high number of Amoxicillin resistant H. pylori. Usually these resistance results are not reproducible.

We also have another collaborator in Guiyang, China, that claim to have 13% Amoxicillin resistant strains. We requested a repeat of the experiment, and they very kindly did it, and no longer able to see those resistant cases again.

So what you're saying is the numbers are not accurate?
Have you seen any data where you did observe amoxicillin resistance in H Pylori that is accurate? Or until now no such verifiable sources have been reported?
Is there any reason why H Pylori can't get resistant to Amoxicillin as opposed to other antibiotics?

We have not seen a real amoxicillin resistant case ourselves.

in most of the resistant articles, they use a lower cut-off threshold. But since amoxicillin is so safe, and can be given in high dose, there is no need to use a lower cut-off threshold.

We are not sure why is amoxicillin so hard to be resistant to. Perhaps the gene involved is so important that it does not tolerate any mutation.