News Release

Resistance to antibiotics doubles in 20 years, new study finds

Peer-Reviewed Publication

Spink Health

Evolution of Primary Antimicrobial Resistance of <em>H. pylori</em> in Europe (1998-2018)

image: Evolution of primary antimicrobial resistance of H. pylori in Europe (1998-2018). view more 

Credit: UEG

(Barcelona, October 21, 2019) Resistance to commonly-used antibiotics for treating harmful bacteria related to a variety of stomach conditions has more than doubled in 20 years, new research presented today at UEG Week Barcelona 2019 has shown.

The study, which analysed 1,232 patients from 18 countries* across Europe, investigated resistance to antibiotics regularly taken for Helicobacter pylori (H. pylori) infection, a harmful bacterium associated with gastric ulcer, lymphoma and gastric cancer. Resistance to clarithromycin, one of the most established antimicrobials used to eradicate H. pylori, had increased from 9.9% in 1998 to 21.6% last year, with increases in resistance also seen for levofloxacin and metronidazole.

Antibiotic resistance occurs when bacteria develop the ability to survive exposure to medications designed to kill or halt their growth. It is one of the greatest threats to global health today, causing more than 750,000 deaths every year and, without urgent action, this number is expected to rise dramatically in the future.

Presenting the study today, lead researcher Professor Francis Megraud, explained, "H. pylori infection is already a complex condition to treat, requiring a combination of medications. With resistance rates to commonly used antibiotics such as clarithromycin increasing at an alarming rate of nearly 1% per year, treatment options for H. pylori will become progressively limited and ineffective if novel treatment strategies remain undeveloped. The reduced efficacy of current therapies could maintain the high incidence rates of gastric cancer and other conditions such as peptic ulcer disease, if drug resistance continues to increase at this pace."

H. pylori is one of the most common bacterial infections in humans and is estimated to be present in one-half of the world's population. H. pylori leads to inflammation of the stomach lining, namely gastritis, which can result in peptic ulcers. H. pylori is also the most important risk factor for gastric cancer, the seventh leading cause of cancer death in Europe and the third worldwide. In recent years, H. pylori antibiotic resistance has become a prominent and urgent issue across the globe. Underlining the severity of the situation, in 2017, the World Health Organisation identified clarithromycin-resistant H. pylori as a high priority bacterium for antibiotic research and development.

The survey also found that the rates of primary clarithromycin resistance in H. pylori were highest in Southern Italy (39.9%), Croatia (34.6) and Greece (30%), aligning with previous reports that predict that both Italy and Greece will have the highest number of deaths due to antimicrobial resistance amongst EU members by 20507. The high levels of resistance exhibited in these countries has been attributed to the overconsumption of antibiotics for conditions including cold and flu, and a lack of institutional support for antibiotic resistance containment strategies.

"The findings of this study are certainly concerning, as H. pylori is the main cause of peptic disease and gastric cancer," commented Mário Dinis-Ribeiro, President of the European Society of Gastrointestinal Endoscopy. "The increasing resistance of H. pylori to a number of commonly-used antibiotics may jeopardize prevention strategies."

The rate of 'primary' clarithromycin resistance in H. pylori in Europe in 2018 (%) found in the study was:

  • Southern Italy: 36.9
  • Croatia: 34.6
  • Greece: 30.0
  • Poland: 28.5
  • Bulgaria: 26.9
  • Ireland: 25.6
  • Austria: 23.5
  • France: 22.5
  • Germany: 22.2
  • Portugal: 20.0
  • Belgium: 17.4
  • Spain: 17.1
  • Slovenia: 16.0
  • Lithuania: 13.0
  • Netherlands: 9.2
  • Norway: 8.9
  • Latvia: 6.8
  • Denmark: 5.0


Notes to Editors

Participating countries included; Austria, Belgium, Bulgaria, Croatia, Denmark, France, Germany, Greece, Ireland, Latvia, Lithuania, The Netherlands, Norway, Poland, Portugal, Slovenia, Southern Italy and Spain.

For further information, or to arrange an interview with Professor Francis Megraud, please contact Luke Paskins on +44 (0)1444 811099 or +44 (0) 7732 499170 or

We kindly ask that a reference to UEG Week 2019 is included when communicating any information within this press release.

About Professor Francis Megraud

Professor Francis Megraud is the Professor of Bacteriology at University of Bordeaux (France) and founder and current secretary of the European Helicobacter & Microbiota Study Group.

About UEG Week

UEG Week is the largest and most prestigious gastroenterology meeting in Europe and has developed into a global congress. It attracts over 14,000 participants each year, from more than 120 countries, and numbers are steadily rising. UEG Week provides a forum for basic and clinical scientists from across the globe to present their latest research in digestive and liver diseases, and also features a two-day postgraduate course that brings together top lecturers in their fields for a weekend of interactive learning.

About UEG

UEG, or United European Gastroenterology, is a professional non-profit organisation combining all the leading European medical specialist and national societies focusing on digestive health. Together, its member societies represent over 30,000 specialists, working across medicine, surgery, paediatrics, gastrointestinal oncology and endoscopy. This makes UEG the most comprehensive organisation of its kind in the world, and a unique platform for collaboration and the exchange of knowledge. To advance the standards of gastroenterological care and knowledge across the world and to reduce the burden of digestive diseases, UEG offers numerous activities and initiatives, including:

  • UEG Week, the biggest congress of its kind in Europe, and one of the two largest in the world
  • UEG Education, the universal source of knowledge in gastroenterology, providing online and classroom courses, a huge online library and delivering the latest GI news, fostering debate and discussion
  • Activity Grants, promoting and funding educational projects in the field of digestive health to advance and harmonise the training and continuing education of professionals
  • UEG Journal, covering translational and clinical studies from all areas of gastroenterology
  • Public Affairs, promoting research, prevention, early diagnosis and treatment of digestive diseases, and helping develop an effective health policy for Europe
  • Quality of Care, European-based and English clinical practice guidelines, clinical standards, consensus, position papers and standard protocols in the field of digestive health, are available in the repository.

Find out more about UEG's work by visiting or contact: Luke Paskins on +44 (0)1444 811099 or


1. Megraud, F et al., 2019. European survey of Helicobacter pylori primary resistance to antibiotics - Evolution over the last 20 years. Presented at UEG Week Barcelona October 21, 2019
2. Glupczynski et al. EJCMID 2001, Megraud et al. Gut 2013 and Megraud, F et al., 2019. European survey of Helicobacter pylori primary resistance to antibiotics - Evolution over the last 20 years
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7. OECD. Stopping antimicrobial resistance would cost just USD 2 per person a year. (ONLINE) Available at:

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