{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T21:02:08Z","timestamp":1791061328834,"version":"4.1.0"},"reference-count":31,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2024,4,29]],"date-time":"2024-04-29T00:00:00Z","timestamp":1714348800000},"content-version":"vor","delay-in-days":59,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Helicobacter"],"published-print":{"date-parts":[[2024,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The systematic use of susceptibility testing and tailored first\u2010line treatment for <jats:italic>Helicobacter pylori<\/jats:italic> eradication has yet to be established.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>To compare 14\u2010day tailored PCR\u2010guided triple therapy to 14\u2010day non\u2010Bismuth concomitant quadruple therapy for first\u2010line <jats:italic>Helicobacter pylori<\/jats:italic> eradication.<\/jats:p><\/jats:sec><jats:sec><jats:title>Patients and Methods<\/jats:title><jats:p>We performed a multicenter, parallel\u2010group, randomized noninferiority controlled trial. Naive adult patients with <jats:italic>Helicobacter pylori<\/jats:italic> infection were treated with 14\u2010day tailored PCR\u2010guided triple therapy (esomeprazole 40\u2009mg and amoxicillin 1000\u2009mg b.d. plus clarithromycin 500\u2009mg or levofloxacin 500\u2009mg b.d. according to clarithromycin susceptibility) or 14\u2010day non\u2010Bismuth concomitant quadruple therapy (esomeprazole 40\u2009mg, amoxicillin 1000\u2009mg, clarithromycin 500\u2009mg, and metronidazole 500\u2009mg b.d.). The primary endpoint was <jats:italic>H. pylori<\/jats:italic> eradication.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We screened 991 patients for eligibility and randomized 241 patients. The first\u2010line eradication rate was 99.2% in the tailored PCR\u2010guided group and 95.9% in the control group (ITT population; absolute difference of +3.30%, with a lower bound of CI at \u22120.68%). Both first\u2010line therapies were well tolerated, with a formally significant difference in favor of the tailored PCR\u2010guided group (61.4% vs. 41.2%, <jats:italic>p<\/jats:italic>\u2009=\u20090.003). Economic analyses revealed a lower cost of the tailored PCR\u2010guided arm, with a 92% chance of being jointly more effective and less expensive than the control arm in the ITT population.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In a country with a high level of clarithromycin resistance, the results of our study demonstrated the noninferiority of 14\u2010day tailored PCR\u2010guided triple therapy as a first\u2010line <jats:italic>H. pylori<\/jats:italic> eradication therapy compared to 14\u2010day non\u2010Bismuth quadruple therapy (<jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"http:\/\/clinicaltrials.gov\">ClinicalTrials.gov<\/jats:ext-link> NCT02576236).<\/jats:p><\/jats:sec>","DOI":"10.1111\/hel.13076","type":"journal-article","created":{"date-parts":[[2024,4,29]],"date-time":"2024-04-29T07:19:42Z","timestamp":1714375182000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["14\u2010day tailored PCR\u2010guided triple therapy versus 14\u2010day non\u2010Bismuth concomitant quadruple therapy for <i>Helicobacter pylori<\/i> eradication: A multicenter, open\u2010label randomized noninferiority controlled trial"],"prefix":"10.1111","volume":"29","author":[{"given":"Aurelien","family":"Amiot","sequence":"first","affiliation":[{"name":"AP\u2010HP, H\u00f4pital Henri Mondor, Department of Gastroent\u00e9rology Universite Paris Est Creteil (UPEC)  Creteil France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00e9r\u00e9my","family":"Hacoon","sequence":"additional","affiliation":[{"name":"AP\u2010HP, H\u00f4pital Henri Mondor, Department of 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