Twice Day Quadruple Therapy for H. Pylori Infection in a Population with a High Metronidazele Resistance Background

a ~BC-UBT to diagnose active H. pylori infection and then underwent EGD to establish the presence of an active ulcer.Biopsies were obtained for culture and histopathology, both pre-treatment and post-treatment, Antimicrobial susceptibility testing by agar dilution was performed on all isolates.Breakpoints used to assess resistance were >0.25 /~g/mL for amoxicillin, >l/~g/mL for clarithromycin and azithromycin.Results: 357 patients were enrolled.The male:female ratio was -2:1, Cure rates were: AAO = 56.7%(95% CI = 48% to 64%); AO = 34.7%;AA = 0%; and C0 = 0%.Macrolide resistance rates for the entire study group was 9.4%.Cross-resistance was present among clarithromycin and azithromycin.Conclusion: Three day azithromycin-PPI based triple therapy was not an efficacious therapy for the treatment of H. pylor/infection.