Culture-Based Antibiotic Resistance Tests

The eradication rate of standard triple therapy, comprising clarithromycin, amoxicillin, and proton-pump inhibitor, widely used for H. pylori eradication, has been declining. Therefore, the eradication rate is reported to be approximately 70–80% and below 70% in 7-day standard triple therapy. This reduction is attributed to increased antibiotic resistance in H. pylori, especially in clarithromycin which is most effective and commonly utilized as a primary eradication regimen. Besides clarithromycin, other antibiotics utilized for H. pylori eradication such as metronidazole, amoxicillin, tetracycline, and quinolone also have shown rising resistance. Moreover, multidrug resistance involving two or more antibiotics is a contemporary challenge, further impacting treatment success rate.