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Personalized Treatment for H.Pylori combats Antibiotic Resistance


Personalized treatment combats antibiotic resistance

H. pylori is a type of bacteria that can infect the stomach lining and cause digestive problems such as stomach ulcers, gastritis, and even stomach cancer. Eradication of this bacteria is crucial to prevent these health issues. However, traditional treatment methods have been unsuccessful in completely eradicating H. pylori. A clinical trial has investigated a tailored triple plus bismuth therapy (TBT) that can achieve higher eradication rates based on previous antibiotic history than empiric therapies.

Clinical Trial

The clinical trial involved 800 treatment-naïve patients who were randomly assigned to four groups receiving clarithromycin-, levofloxacin- or metronidazole-containing empiric TBT and tailored TBT (clarithromycin and levofloxacin chosen based on previous macrolides and quinolones medication history). Correlation analyses were performed between past medication history and resistance or eradication rate. The objective of the study was to determine whether tailored therapy based on past medication history can improve the efficacy of H. pylori eradication compared to empiric therapies.


The results of the clinical trial were significant. The eradication rates of tailored TBT were significantly higher than clarithromycin-, levofloxacin- and metronidazole-containing empiric TBT in both intention-to-treat and per-protocol analyses. The tailored therapy achieved an eradication rate of 89.5% in the intention-to-treat analysis and 95.1% in the per-protocol analysis, while the empiric therapies achieved eradication rates ranging from 80.8% to 81.5% in the intention-to-treat analysis and 86.5% to 87.8% in the per-protocol analysis. These results show that tailored TBT is a more effective treatment option than empiric TBTs for first-line H. pylori eradication.

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The study also found that in patients with previous macrolides, quinolones, or nitroimidazoles medication history, the resistance rates of corresponding clarithromycin, levofloxacin, or metronidazole were significantly higher than in patients without past medication history. The eradication rates of corresponding clarithromycin- or levofloxacin-containing empiric TBT were also significantly lower in these patients. These findings suggest that tailored TBT based on previous antibiotic history can help overcome antibiotic resistance and improve eradication rates.


This clinical trial highlights the importance of tailored therapy based on past medication history in achieving higher eradication rates for H. pylori. It provides evidence that tailored triple plus bismuth therapy can be an effective treatment option for first-line H. pylori eradication. This approach can help overcome antibiotic resistance and improve the efficacy of H. pylori eradication, ultimately leading to better health outcomes for patients with H. pylori infection. It is essential to consult with a healthcare professional before starting any treatment for H. pylori infection to determine the most appropriate course of action based on individual medical history and other factors.

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This content is for informational and educational purposes only. It is not intended to provide medical advice or to take the place of such advice or treatment from a personal physician. All readers/viewers of this content are advised to consult their doctors or qualified health professionals regarding specific health questions. CenTrial Data Ltd. does not take responsibility for possible health consequences of any person or persons reading or following the information in this educational content. Treatments and clinical trials mentioned may not be appropriate or available for all trial participants. Outcomes from treatments and clinical trials may vary from person to person. Consult with your doctor as to whether a clinical trial is a suitable option for your condition. Assistance from generative AI tools may have been used in writing this article.