title: Helicobacter pylori in Iran: A systematic review on the antibiotic resistance.
abstract: OBJECTIVE
  Helicobacter pylori (H. pylori) is a pathogenic bacterium that colonizes the stomachs of approximately 50% of the world's population. Resistance of H. pylori to antibiotics is considered as the main reason for the failure to eradicate this bacterium. The aim of this study was to determine the rate of resistant H. pylori strains to various antimicrobial agents in different areas of Iran.
  
  
  METHODS
  A systematic review of literatures on H. pylori antibiotic resistance in Iran was performed within the time span of 1997 to 2013. Data obtained from various studies were tabulated as following, 1) year of research and number strains tested, 2) number of H. pylori positive patients, 3) study place, 4) resistance of H. pylori to various antibiotics as percentage, and 5) methods used for evaluation of antibiotic resistance.
  
  
  RESULTS
  Over the period, a total of 21 studies on H. pylori antibiotic resistance have been conducted in different parts of Iran. In these studies, H. pylori resistance to various antibiotics, including metronidazole, clarithromycin, amoxicillin, tetracycline, ciprofloxacin, levofloxacin and furazolidone were 61.6%, 22.4%, 16.0%, 12.2%, 21.0%, 5.3% and 21.6%, respectively. We found no study on H. pylori resistance to rifabutin in Iran.
  
  
  CONCLUSIONS
  Compared to the global average, we noted that the prevalence of H. pylori resistance to metronidazole, clarithromycin, amoxicillin, and tetracycline has been rapidly growing in Iran. This study showed that in order to determine an appropriate drug regimen against H. pylori, information on antibiotic susceptibility of the bacterium within different geographical areas of Iran is required.
authors: Antimicrobial Resistance Research Center, Department of Medical Bacteriology and Virology, Qaem University Hospital, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
authors: Farzad
authors: F
authors: Khademi
authors: Department of Microbiology, School of Medicine¸ Isfahan University of Medical Sciences, Isfahan, Iran.
authors: Farkhondeh
authors: F
authors: Poursina
authors: Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
authors: Elham
authors: E
authors: Hosseini
authors: Department of Biostatistics and Epidemiology, School of Medicine¸ Isfahan University of Medical Sciences, Isfahan, Iran.
authors: Mojtaba
authors: M
authors: Akbari
authors: Antimicrobial Resistance Research Center, Department of Medical Bacteriology and Virology, Qaem University Hospital, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
authors: Hajieh Ghasemian
authors: HG
authors: Safaei
keywords: Antibiotic resistance; Helicobacter pylori; Iran