Digestive Diseases and Sciences

, Volume 51, Issue 12, pp 2316–2321 | Cite as

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
Original Article


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.


Helicobacter pylori Culture-guided therapy Treatment failure 


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Copyright information

© Springer Science+Business Media, Inc. 2006

Authors and Affiliations

  • Jacob Yahav
    • 1
    • 5
  • Zmira Samra
    • 1
    • 2
    • 5
  • Yaron Niv
    • 1
    • 3
    • 5
  • Charlesnika T. Evans
    • 6
  • Douglas J. Passaro
    • 6
  • Gabriel Dinari
    • 1
    • 4
    • 5
  • Haim Shmuely
    • 1
    • 5
    • 7
  1. 1.Helicobacter Research InstituteRabin Medical Center, Beilinson CampusPetah TiqvaIsrael
  2. 2.Microbiology LaboratoryRabin Medical Center, Beilinson CampusPetah TiqvaIsrael
  3. 3.Department of GastroenterologyRabin Medical Center, Beilinson CampusPetah TiqvaIsrael
  4. 4.Department of Pediatric Gastroenterology and NutritionSchneider Children’s Medical Center of IsraelPetah TiqvaIsrael
  5. 5.Sackler Faculty of MedicineTel Aviv UniversityTel AvivIsrael
  6. 6.Division of Epidemiology and BiostatisticsUniversity of Illinois School of Public HealthChicagoUSA
  7. 7.Department of Internal Medicine CHelicobacter Research Institute, Rabin Medical Center, Beilinson CampusPetah TiqvaIsrael

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