Helicobacter pylori is a persistent gastric pathogen associated with chronic gastritis, peptic ulcer disease, gastric mucosa-associated lymphoid tissue lymphoma, and non-cardia gastric cancer. Although eradication can prevent important clinical outcomes, increasing resistance to clarithromycin, metronidazole, and fluoroquinolones has undermined historically successful empirical regimens. This narrative review critically examines the biological and clinical drivers of eradication failure, current resistance-aware therapeutic approaches, and emerging diagnostic and treatment strategies. Evidence was selected from major international guidelines, systematic reviews, clinical trials, and recent translational studies, with emphasis on literature published between 2022 and 2026. Contemporary recommendations prioritize optimized 14-day bismuth quadruple therapy when susceptibility is unknown, while rifabutin-based regimens and vonoprazan-amoxicillin dual therapy offer alternatives for selected patients. Molecular resistance testing, adequate acid suppression, treatment adherence, and systematic confirmation of eradication are central to precision management. Probiotics may reduce adverse effects in some settings but cannot replace antimicrobial therapy. Antimicrobial peptides, biofilm-disrupting compounds, targeted delivery systems, bacteriophage-derived approaches, and vaccines remain largely investigational. Future progress will depend on integrating locally relevant resistance surveillance, validated susceptibility testing, antimicrobial stewardship, and equitable access to effective regimens. This review provides a practical synthesis of established strategies and emerging opportunities while emphasizing the need to distinguish clinical evidence from preclinical promise.

Introduction: Candidemia is a severe invasive fungal infection caused by Candida species. It primarily affects immunocompromised patients and those admitted to intensive care units. Depending on the geographic region, Candida tropicalis ranks as the second or third most common cause of candidemia and is associated with high mortality. Materials and Methods: We conducted a retrospective descriptive study at Hassan II University Hospital in Fez, Morocco, from January 2016 to October 2025. We included all patients with blood cultures positive for C. tropicalis. We identified the isolates using culture, biochemical tests, and multiplex polymerase chain reaction (PCR). We performed antifungal susceptibility testing to assess susceptibility to the antifungal agents tested. Results: We included 33 patients, accounting for 21.9% of all candidemia cases. The mean age was 32 years, and the study population included 11 females and 22 males. The reported risk factors included neutropenia (9 cases), central venous catheter colonization (5 cases), and prior broad-spectrum antibiotic therapy (all patients). Among the isolates with reported susceptibility results, 16 were susceptible to all tested antifungal agents, 9 were susceptible only to caspofungin, and 3 were reported as multidrug-resistant. Overall mortality was 57.6%. Conclusion: C. tropicalis is an important cause of severe candidemia. The main reported risk factors were neutropenia, central venous catheter colonization, and prior exposure to broad-spectrum antibiotics. The high mortality rate and reported antifungal resistance highlight the importance of early diagnosis, appropriate antifungal treatment, and targeted preventive measures.