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The increasing indications for <jats:italic>H.\u00a0pylori<\/jats:italic> treatment (idiopathic thrombocytopenia and iron deficiency anemia) and an increasing trend of antibiotic resistance (especially in southern Europe) emphasize the need for more effective <jats:italic>H.\u00a0pylori<\/jats:italic> eradication. Smoking and a short duration of treatment, especially in patients with functional dyspepsia, are predictors of eradication failure. In first line, the best option remains the clarithromycin\u2010based regimens but an extended treatment duration is now indicated. Following first\u2010line treatment failure, 14\u2010day proton pump inhibitor triple therapy employing alternative antibiotics or quadruple therapy could be used. 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