The investigators investigated the point mutations in the 23S rRNA genes of patients infected with clarithromycin-resistant H. pylori and compared the H. pylori eradication rates based on the identified clinically significant point mutations.

Sequencing-based detection of point mutations identified four mutations that were considered clinically significant (A2142G, A2142C, A2143G, A2143C), while all the other mutations were considered clinically insignificant.

Participants who did not have point mutations related to clarithromycin resistance and/or had clinically insignificant point mutations were treated with PAC (proton pump inhibitor, amoxicillin, clarithromycin) for 7 days, while participants with clinically significant point mutations were treated with PAM (proton pump inhibitor, amoxicillin, metronidazole) for 7 days. H. pylori eradication rates were compared between the two groups.

Inclusion Criteria:

• Clinical diagnosis of Helicobacter pylori infection

Exclusion Criteria:

• H. pylori eradication therapy within 1 year,
• antibiotics within 4 weeks,
• surgery for gastric cancer
• malignant tumors other than gastric cancer
• end-stage renal disease
• liver cirrhosis,
• pregnancy

Helicobacter-pylori positive patients with gastritis, ulcer, adenoma