Full Length Research Paper

An overview of antimicrobial resistance and the future of medicinal plants in the treatment of Helicobacter pylori infections

C. Njume¹, A. J. Afolayan¹ and R. N. Ndip^{1, 2}*

¹School of Biological and Environmental Sciences, Faculty of Science and Agriculture, University of Fort Hare, P/Bag X1314, Alice 5700, South Africa.

²Department of Biochemistry and Microbiology, Faculty of Science, University of Buea, Box 63, Cameroon.

*Corresponding author. E-mail: rndip@ufh.ac.za; ndip3@yahoo.com.

Tel: +27(0) 406 022364. Fax: +27 (0) 406 6531730.

 Abstract

Helicobacter pylori, a gram negative helical bacillus that inhabits the human stomach is now recognised as the causative agent of chronic gastritis, peptic ulcer, duodenal ulcer and mucosa associated lymphoid tissue (MALT) lymphoma. The treatment of H. pylori infection typically employs a triple drug regimen using two antibiotics and a proton pump inhibitor (PPI) or bismuth with a success rate of 80 - 90%. However, resistance to the most commonly used antibiotics is a growing global concern. With an alarming H. pylori prevalence of 90% reported in some African countries and 90 - 100% metronidazole (MTZ)-resistance, one of the drugs used in the treatment regimen, the need for alternative treatment regimens is imperative. Medicinal plants seem to provide an alternative source of treatment and are among the attractive sources of new drugs shown to produce promising results against H. pylori in-vitro. Researchers have been testing crude extracts of a wide variety of plants used in folklore medicine for the identification of potential anti- H. pylori agents. This review appraises the current state of H. pylori antimicrobial resistance, medicinal plant constituents ranging from extracts commonly in use, by the lay community, to substances being prospected and tested by researchers as possible substitutes to treat H. pylori infection. There is a need to continue to monitor resistance and revolutionize the search for alternative treatment regimens against H. pylori particularly as the life span of any drug is limited.

Key words: Helicobacter pylori, drug resistance, antibiotics, alternative treatment, medicinal plants.