| Helicobacter pyloriis a common gastric bacterial pathogen implicated in the pathogenesis of many digestivetract disorders.H. pyloriinfection prevalence has been reported alarmingly in Iran. A plethora of studies havebeen conducted to evaluate the efficiency of first-line and second-line eradication attempts in patients diag-nosed withH. pyloriinfections in Iran. The present study, was evaluated the efficacy of first-line and second-line therapy inH. pyloriinfections in Iran. We aimed to consider the literature review of the various library andelectronic databases (Science Direct, PubMed, and Google Scholar) until 2020. The frequency of bacterialresistance to tetracycline, ampicillin, trimethoprim, erythromycin, ofloxacin, and metronidazolewas found to behigh in Iran, while the most effective antibiotics were clarithromycin, rifampin, rifampicin, tetracycline, amoxicil-lin, ciprofloxacin, levofloxacin, moxifloxacin, and azithromycin. The therapeutic choice forH. pylorieradicationin Iran could be quadruple therapy using two antibiotics amoxicillin and metronidazole/clarithromycin for thefirst-line regimen, and a combination of furazolidone plus tetracycline/amoxicillin and bismuth plus protonpump inhibitor for the second-line regimen. Due to increased antibiotic resistance in our region, empiricaltherapy must be replaced by more targeted treatment based on antimicrobial drug resistance profilesobtained from patients. Although we limited our investigation on theH. pylorieradication regimens in Iran, theresults can be generalized to any region as long as the patterns of resistance are the same |