Molecular Susceptibility Testing for H. pylori Enables Resistance-Guided Therapy from Stool Specimens

This review focuses on the evolving diagnostics landscape for H. pylori with emphasis on susceptibility-guided treatment, now recommended by major guidelines due to alarming resistance levels. Molecular tests performed directly on stool and endoscopic specimens can detect resistance mutations, bypassing the need for difficult culture-based susceptibility testing. The shift toward molecular resistance detection represents a paradigm change in H. pylori management from empiric to precision therapy.