Susceptibility-guided vs. empiric retreatment of Helicobacter pylori infection after treatment failure

Jacob Yahav, Zmira Samra, Yaron Niv, Charlesnika T. Evans, Douglas J. Passaro, Gabriel Dinari, Haim Shmuely

Research output: Contribution to journalArticlepeer-review

27 Scopus citations


Successful eradication of Helicobacter pylori after failure of standard triple therapy is difficult because of the higher resistance to metronidazole and clarithromycin. We evaluated the efficacy of susceptibility-guided vs. empiric retreatment for H. pylori after at least one treatment failure and determined the prevalence of posttreatment antibiotic resistance. Forty-nine patients in whom at least one treatment regimen for H. pylori eradication had failed underwent gastric biopsy and culture and were retreated according to the in vitro susceptibility results. Findings were compared with those for 49 control patients referred to our center for a 13C-urea breath test. H. pylori eradication was assessed by urea breath test at least 6 weeks after retreatment in both groups. Susceptibility-guided retreatment was associated with better eradication rates than empiric treatment. The difference remained significant in stratified and multivariate analysis. Susceptibility-guided retreatment appears to be significantly more effective than empiric retreatment in eradicating H. pylori after at least one previous treatment failure.

Original languageEnglish
Pages (from-to)2316-2321
Number of pages6
JournalDigestive Diseases and Sciences
Issue number12
StatePublished - Dec 2006
Externally publishedYes


  • Culture-guided therapy
  • Helicobacter pylori
  • Treatment failure


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