{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T23:23:52Z","timestamp":1787009032031,"version":"build-2736575974"},"reference-count":18,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2023,1,31]],"date-time":"2023-01-31T00:00:00Z","timestamp":1675123200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"crossref","award":["81970497"],"award-info":[{"award-number":["81970497"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"crossref","award":["82170578"],"award-info":[{"award-number":["82170578"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,3,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and objectives<\/jats:title>\n                    <jats:p>High-dose dual therapy [proton pump inhibitor (PPI)\u200a+\u200aamoxicillin] is recommended as a Helicobacter pylori rescue treatment. However, its efficacy is still controversial. The aim of this study was to evaluate the efficacy and safety of triple therapy containing high dose of PPI and amoxicillin plus metronidazole compared with dual therapy in rescue treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Two hundred and sixty-eight patients who failed at least two courses of H. pylori treatment were recruited and randomly allocated into two 14-day groups: esomeprazole 40 mg twice daily and amoxicillin 1000 mg three times daily plus metronidazole 400 mg three times daily (EAM group); or esomeprazole 40 mg twice daily and amoxicillin 1000 mg three times daily (EA group). The agar-dilution method was performed as an antibiotic susceptibility test. The 13C urea breath test was used to assess H. pylori eradication at 6 weeks after the treatment. The study was registered at clinicaltrials.gov (NCT04024527).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>H. pylori eradication rates in the EAM group were 85.8% (115\/134, 95% CI 79.9%\u201391.7%) in ITT analysis and 92.6% (113\/122, 95% CI 87.9%\u201397.3%) in PP analysis, significantly higher than those of the EA group, which were 73.1% (98\/134, 95% CI 65.6%\u201380.6%) and 83.1% (98\/118, 95% CI 76.8%\u201389.8%) (P\u200a=\u200a0.005, 0.011). Resistance rates of amoxicillin and metronidazole were 6.6% (13\/196) and 89.8% (176\/196). Metronidazole resistance did not affect the eradication rates in the EAM group. Both groups had similar moderate and severe adverse events and similar compliance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>A triple therapy containing high dose of PPI and amoxicillin plus metronidazole could be a potential rescue therapy worldwide even in a high metronidazole-resistance region.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/jac\/dkad020","type":"journal-article","created":{"date-parts":[[2023,1,14]],"date-time":"2023-01-14T00:32:35Z","timestamp":1673656355000},"page":"828-831","source":"Crossref","is-referenced-by-count":12,"title":["A randomized superiority clinical trial: metronidazole improved the efficacy of high-dose dual therapy in\n                    <i>Helicobacter pylori<\/i>\n                    rescue treatment"],"prefix":"10.1093","volume":"78","author":[{"given":"Zhao-Hui","family":"Ding","sequence":"first","affiliation":[{"name":"Division of Gastroenterology and Hepatology, NHC Key Laboratory of Digestive Diseases, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Institute of Digestive Disease , Shanghai , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu","family":"Huang","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, NHC Key Laboratory of Digestive Diseases, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Institute of Digestive Disease , Shanghai , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jin-Nan","family":"Chen","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, NHC Key Laboratory of Digestive Diseases, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Institute of Digestive Disease , Shanghai , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lai-Sheng","family":"Luo","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, NHC Key Laboratory of Digestive Diseases, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Institute of Digestive Disease , Shanghai , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Zhang","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, NHC Key Laboratory of Digestive Diseases, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Institute of Digestive Disease , Shanghai , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiao","family":"Liang","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, NHC Key Laboratory of Digestive Diseases, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Institute of Digestive Disease , Shanghai , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3127-6048","authenticated-orcid":false,"given":"Hong","family":"Lu","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, NHC Key Laboratory of Digestive Diseases, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Institute of Digestive Disease , Shanghai , China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2023,1,31]]},"reference":[{"key":"2023030208094471400_","doi-asserted-by":"crossref","first-page":"5118","DOI":"10.3748\/wjg.v16.i40.5118","article-title":"Resistance of Helicobacter pylori to antibiotics from 2000 to 2009 in Shanghai","volume":"16","author":"Sun","year":"2010","journal-title":"World J Gastroenterol"},{"key":"2023030208094471400_","doi-asserted-by":"crossref","DOI":"10.1136\/gutjnl-2022-327745","article-title":"Management of Helicobacter pylori infection: the Maastricht VI\/Florence consensus report","author":"Malfertheiner","year":"2022","journal-title":"Gut"},{"key":"2023030208094471400_","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1053\/j.gastro.2016.04.006","article-title":"The Toronto consensus for the treatment of Helicobacter pylori infection in adults","volume":"151","author":"Fallone","year":"2016","journal-title":"Gastroenterology"},{"key":"2023030208094471400_","doi-asserted-by":"crossref","first-page":"1736","DOI":"10.1038\/ajg.2016.443","article-title":"Rescue therapy for Helicobacter pylori eradication: a randomized non-inferiority trial of amoxicillin or tetracycline in bismuth quadruple therapy","volume":"111","author":"Chen","year":"2016","journal-title":"Am J 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