{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T19:44:30Z","timestamp":1791229470145,"version":"4.1.0"},"reference-count":28,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2024,6,17]],"date-time":"2024-06-17T00:00:00Z","timestamp":1718582400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100017635","name":"Korean College of Helicobacter and Upper Gastrointestinal Research","doi-asserted-by":"publisher","award":["KCHUGR\u2010201902505"],"award-info":[{"award-number":["KCHUGR\u2010201902505"]}],"id":[{"id":"10.13039\/501100017635","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["UEG Journal"],"published-print":{"date-parts":[[2024,9]]},"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n \n With the increasing resistance to antimicrobial agents, susceptibility\u2010guided tailored therapy has been emerging as an ideal strategy for\n Helicobacter pylori<\/jats:italic>\n treatment. However, susceptibility\u2010guided tailored therapy requires additional cost, time consumption, and invasive procedure (endoscopy) and its superiority over empirical quadruple therapy as the first\u2010line\n H<\/jats:italic>\n .\n pylori<\/jats:italic>\n treatment remains unclear.\n <\/jats:p>\n <\/jats:sec>\n \n Aims<\/jats:title>\n \n To compare the efficacy of culture\u2010based susceptibility\u2010guided tailored versus empirical concomitant therapy as the first\u2010line\n Helicobacter pylori<\/jats:italic>\n treatment.\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n This open\u2010label, randomized trial was performed in four Korean institutions. A total of 312 Patients with\n H<\/jats:italic>\n .\n pylori\u2010<\/jats:italic>\n positive culture test and na\u00efve to treatment were randomly assigned in a 3:1 ratio to either culture\u2010based susceptibility\u2010guided tailored therapy (clarithromycin\u2010based or metronidazole\u2010based triple therapy for susceptible strains or bismuth quadruple therapy for dual\u2010resistant strains,\n n<\/jats:italic>\n \u00a0=\u00a0234) or empirical concomitant therapy (\n n<\/jats:italic>\n \u00a0=\u00a078) for 10 days. Eradication success was evaluated by\n 13<\/jats:sup>\n C\u2010urea breath test at least 4\u00a0weeks after treatment.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Prevalence of dual resistance to both clarithromycin and metronidazole was 8%.\n H. pylori<\/jats:italic>\n eradication rates for tailored and concomitant groups were 84.2% and 83.3% by intention\u2010to\u2010treat analysis (\n p<\/jats:italic>\n \u00a0=\u00a00.859), respectively, and 92.9% and 91.5% by per\u2010protocol analysis, respectively (\n p<\/jats:italic>\n \u00a0=\u00a00.702), which were comparable between the two groups. However, eradication rates for dual\u2010resistant strains were significantly higher in the tailored group than in the concomitant group. All adverse events were grade 1 or 2 based on the Common Terminology Criteria for Adverse Events and the incidence was significantly lower in the tailored group. The proportion of patients discontinuing treatment for adverse events was comparable between the two groups (2.1% vs. 2.6%).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n The culture\u2010based susceptibility\u2010guided tailored therapy failed to show superiority over the empirical concomitant therapy in terms of eradication rate. Based on these findings, the treatment choice in clinical practice would depend on the background rate of antimicrobial resistance, availability of resources and costs associated with culture and susceptibility testing.<\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/ueg2.12609","type":"journal-article","created":{"date-parts":[[2024,6,18]],"date-time":"2024-06-18T01:40:23Z","timestamp":1718674823000},"page":"941-950","source":"Crossref","is-referenced-by-count":16,"title":["Culture\u2010based susceptibility\u2010guided tailored versus empirical concomitant therapy as first\u2010line\n Helicobacter pylori<\/i>\n treatment: A randomized clinical trial"],"prefix":"10.1002","volume":"12","author":[{"given":"Jeong Hoon","family":"Lee","sequence":"first","affiliation":[{"name":"Department of Gastroenterology Asan Medical Center University of Ulsan College of Medicine Seoul 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Kyong","family":"Na","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Asan Medical Center University of Ulsan College of Medicine Seoul Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ji Yong","family":"Ahn","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Asan Medical Center University of Ulsan College of Medicine Seoul Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4250-4683","authenticated-orcid":false,"given":"Do Hoon","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Asan Medical Center University of Ulsan College of Medicine Seoul Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kee Don","family":"Choi","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Asan Medical Center University of Ulsan College of Medicine Seoul 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