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Updated: Apr 5, 2026
Gastric Mucosa Quantitative Polymerase Chain Reaction Analysis for Detecting Helicobacter pylori and Antibiotic Resistance
Published on: March 7, 2025
Outcome of second- and third-line Helicobacter pylori eradication therapies based on antimicrobial susceptibility
Sarah Draeger1, Nicole Wüppenhorst1, Manfred Kist1
1National Reference Centre for Helicobacter pylori, Department of Medical Microbiology and Hygiene, Institute of Medical Microbiology and Hygiene, University Medical Centre Freiburg, Hermann-Herder-Straße 11, 79104 Freiburg, Germany.
Objectives:
The objective of this study was to assess the outcome of antimicrobial susceptibility-guided therapies in Helicobacter pylori-infected individuals who had undergone unsuccessful prior eradication treatments.
Methods:
From October 2004 to December 2013, 481 H. pylori-positive patients with prior unsuccessful eradication treatments were administered susceptibility-guided salvage eradication treatments. Six months on, treatment outcome was assessed by urea breath test, stool antigen ELISA, Helicobacter urease test or microbiology and/or histopathology.
Results:
Resistance to metronidazole and clarithromycin was high in patients with prior unsuccessful eradication treatments and was dependent on the number of treatment failures. Susceptibility-guided salvage eradication treatments achieved eradication rates of nearly 70% in these patients. No particular regimen was significantly better than another.
Conclusions:
Antimicrobial susceptibility testing prevents prescription of inefficient antimicrobials and enables individualized and promising salvage treatments in patients with prior unsuccessful eradication treatments.
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