{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T21:02:09Z","timestamp":1791061329685,"version":"4.1.0"},"reference-count":24,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T00:00:00Z","timestamp":1760918400000},"content-version":"vor","delay-in-days":49,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82170562"],"award-info":[{"award-number":["82170562"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Helicobacter"],"published-print":{"date-parts":[[2025,9]]},"abstract":"ABSTRACT<\/jats:title>\n \n Background<\/jats:title>\n \n Tailored therapy based on genetic testing of fecal samples is a promising method for\n \n Helicobacter pylori<\/jats:italic>\n <\/jats:styled-content>\n eradication, but relevant research is still lacking, and the effectiveness remains unclear.\n <\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n This study conducted a randomized controlled trial to evaluate the efficacy, safety, and compliance of triple plus bismuth therapy (TBT) guided by clarithromycin and levofloxacin genotypic resistances and CYP2C19 polymorphisms from stool samples. A preliminary health economics analysis was also conducted.<\/jats:p>\n <\/jats:sec>\n \n Design<\/jats:title>\n \n Six hundred and sixteen treatment\u2010na\u00efve patients were randomly divided into tailored (individualized drug selection based on genetic testing for 7 or 14\u2009days) and empiric (esomeprazole 20\u2009mg, amoxicillin 1000\u2009mg, clarithromycin 500\u2009mg, and bismuth potassium citrate 220\u2009mg, all twice daily for 14\u2009days) TBT groups. Safety and compliance were assessed within 1\u20133\u2009days after eradication.\n 13<\/jats:sup>\n C\u2010urea breath test was performed within 4\u20138\u2009weeks after eradication to evaluate the therapeutic outcome.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n The eradication rates of the tailored TBT group were non\u2010inferior to those of the empiric TBT group [intention\u2010to\u2010treat analysis 87.7% vs. 80.8%, rate difference 6.8% (95% confidence interval 0.8%\u201312.9%); modified intention\u2010to\u2010treat analysis 93.4% vs. 86.8%, rate difference 6.7% (95% confidence interval 1.5%\u201311.9%); per\u2010protocol analysis 95.7% vs. 88.7%, rate difference 7.0% (95% confidence interval 2.2%\u201311.8%)]. The tailored TBT group achieved satisfactory efficacies (acceptable in intention\u2010to\u2010treat and excellent in per\u2010protocol analyses). Safety and compliance were similar between the two groups. The average cost of each successful eradication case in the tailored TBT group is lower than that in the empiric TBT group.<\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n \n The tailored TBT guided by antibiotic genotypic resistances and CYP2C19 polymorphisms detected from fecal specimens achieved satisfactory efficacy, safety, and compliance in the first\u2010line\n \n Helicobacter pylori<\/jats:italic>\n <\/jats:styled-content>\n eradication with less expenses (ChiCTR2300068620).\n <\/jats:p>\n <\/jats:sec>\n \n Trial Registration<\/jats:title>\n Chinese Clinical Trials Registration: ChiCTR2300068620<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/hel.70082","type":"journal-article","created":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T04:57:26Z","timestamp":1761022646000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Tailored Therapy Guided by Antibiotic Genotypic Resistances and\n CYP2C19<\/scp>\n Polymorphisms Detected From Fecal Specimens for the First\u2010Line\n \n Helicobacter pylori<\/i>\n <\/scp>\n Eradication: A Randomized Controlled Trial"],"prefix":"10.1111","volume":"30","author":[{"given":"Baojun","family":"Suo","sequence":"first","affiliation":[{"name":"Department of Gastroenterology Peking University Third Hospital Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4778-5373","authenticated-orcid":false,"given":"Xinlu","family":"Ren","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Peking University Third Hospital Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cailing","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Peking University Third Hospital Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanyan","family":"Shi","sequence":"additional","affiliation":[{"name":"Research Center of Clinical Epidemiology Peking University Third Hospital Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xueli","family":"Tian","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Peking University Third Hospital Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kai","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Peking University Third Hospital Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2064-5522","authenticated-orcid":false,"given":"Liya","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Peking University Third Hospital Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0976-419X","authenticated-orcid":false,"given":"Zhiqiang","family":"Song","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Peking University Third Hospital Beijing 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