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Updated: Feb 17, 2026
Gastric Mucosa Quantitative Polymerase Chain Reaction Analysis for Detecting Helicobacter pylori and Antibiotic Resistance
Published on: March 7, 2025
Inappropriate treatment in Helicobacter pylori eradication failure: a retrospective study
Huiyi Li1, Xiao Liang1, Qi Chen1
1a Division of Gastroenterology and Hepatology, Key Laboratory of Gastroenterology & Hepatology, Ministry of Health , Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai Institution of Digestive Disease , Shanghai , China.
Background:
In recent years, success rates of empirical H. pylori therapies have fallen in many countries. Although antibiotic resistance and poor adherence are described as the main factors for treatment failure, in China, iatrogenic factors also play an important role.
Objective:
To investigate why patients experienced multiple failures, we performed a retrospective, single center study using questionnaires to identify causes of treatment failure other than antibiotic resistance.
Methods:
This study was conducted from January 2016 to July 2017 in a general hospital. Patients with at least two H. pylori treatment failures who completed the questionnaire were entered. The survey covered characteristics of the study population, regimens used, and adherence to therapy.
Results:
Two hundred and ninety three patients were included in the final analysis. The top three most antibiotic combinations as the first-line treatment were a PPI plus clarithromycin-metronidazole (24.6%, 72/293), clarithromycin-levofloxacin (23.5%, 69/293) and clarithromycin-amoxicillin (21.5%, 63/293). Clarithromycin-containing regimens were repeatedly used in 178 patients (60.8%) and levofloxacin-containing regimens repeatedly in 88 patients (30.0%). Fifty patients (17.1%) had poor adherence per treatment history and 32 (10.9%) stopped treatment because of nonmedical reasons.
Conclusions:
In order to increase the success of H. pylori eradication therapy, the effect of prior therapies needs to be given more consideration. Patient education to enhance adherence also needs to be improved.
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