**5. Conclusions**

Eradication therapy is considered as the basis for the elimination of *H. pylori* infection, which leads to a cure for chronic gastritis and a decrease the risk of occurrence and recurrence of erosive and ulcerative lesions of the gastric and duodenal mucosa, prevention of the development and progression of precancerous changes in the gastric mucosa (atrophic gastritis, intestinal metaplasia) and primary prevention of gastric cancer. The main reason for the decrease in the effectiveness of eradication therapy regimens is the formation and increase in *H. pylori* resistance to antibiotics.

*H. pylori* antibiotic resistance is a consequence of the use of ineffective eradication therapy regimens and the widespread use of macrolides and fluoroquinolones for various indications, which leads to the development of corresponding mutations in the *H. pylori* genes. The latest Maastricht VI international consensus recommends individualized prescription of eradication regimens, taking into account antibiotic resistance, as well as empiric therapy, considering also account regional differences in resistance and therapeutic efficacy. These recommendations make it actualize the introduction and increase in the availability of methods for determining the resistance of *H. pylori* to antibiotics, both phenotypic and molecular genetics.

Further investigation of the regional peculiarities of *H. pylori* resistance to antimicrobial agents is crucial, as there are geographical differences in the distribution of bacterial resistance. Accumulation of data on regional features of *H. pylori* antibiotic resistance, assessment of its genetic determinants in combination with the diagnosis of *H. pylori* resistance before the administration anti-*Helicobacter* therapy will make it possible to contain the growth of *H. pylori* antibiotic resistance and increase effectiveness anti-*Helicobacter* therapy.

**Author Contributions:** All authors have read and agreed to the published version of the manuscript.

**Funding:** This research received no external funding.

**Data Availability Statement:** Not applicable.

**Conflicts of Interest:** The authors declare no conflict of interest.
