{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,11]],"date-time":"2026-07-11T20:44:54Z","timestamp":1783802694615,"version":"3.55.0"},"reference-count":35,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2019,2,25]],"date-time":"2019-02-25T00:00:00Z","timestamp":1551052800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100001321","name":"National Research Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001321","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Gastro and Hepatol"],"published-print":{"date-parts":[[2019,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and Aim<\/jats:title><jats:p>Failure of bismuth quadruple therapy for <jats:italic>Helicobacter pylori<\/jats:italic> eradication is frequently observed. To increase the eradication rate, comprehensive analyses need to be performed regarding risk factors of bismuth quadruple therapy failure based on complete standard culture and antimicrobial susceptibility testing results.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients with history of failed first therapy who had <jats:styled-content style=\"fixed-case\"><jats:italic>H.\u00a0pylori<\/jats:italic><\/jats:styled-content> colonies isolated from culture and successful minimum inhibitory concentration (MIC) test were enrolled. Esomeprazole, bismuth, metronidazole, and tetracycline (quadruple) therapies for 7 or 14\u00a0days were given. Eradication rate, treatment compliance, adverse events, and risk factors for the failure of bismuth quadruple therapy were analyzed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total 54 patients were enrolled. Overall eradication rate in the present study was 88.8%. The eradication rate for cases with metronidazole resistance such as MIC 8\u201316\u00a0\u03bcg\/mL or 16\u201332\u00a0\u03bcg\/mL was 92.8% (13\/14). For cases with high level metronidazole resistance (MIC &gt;\u00a032\u00a0\u03bcg\/mL), the eradication rate was only 60% (6\/10). Multivariate analysis regarding compliance, treatment duration, age\u00a0&gt;\u00a060, three kinds of metronidazole MICs, tetracycline MIC &gt;\u00a04\u00a0\u03bcg\/mL, adverse events and any other parameters, \u201cmetronidazole resistance, high level (MIC\u00a0&gt;\u00a032\u00a0\u03bcg\/mL)\u201d was the only independent risk factor for eradication failure (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.007).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>For cases with metronidazole resistance at MIC\u00a0&gt;\u00a032\u00a0\u03bcg\/mL, rescue therapy other than bismuth\u2010containing quadruple therapy is needed.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jgh.14625","type":"journal-article","created":{"date-parts":[[2019,2,6]],"date-time":"2019-02-06T20:43:20Z","timestamp":1549485800000},"page":"666-672","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Risk factors of rescue bismuth quadruple therapy failure for <i>Helicobacter pylori<\/i> eradication"],"prefix":"10.1111","volume":"34","author":[{"given":"Jung Won","family":"Lee","sequence":"first","affiliation":[{"name":"Department of Internal Medicine Seoul National University Bundang Hospital  Seongnam Korea"},{"name":"Department of Internal Medicine Samsung Changwon Hospital, Sungkyunkwan University School of Medicine  Changwon Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9397-0406","authenticated-orcid":false,"given":"Nayoung","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Seoul National University Bundang Hospital  Seongnam Korea"},{"name":"Department of Internal Medicine and Liver Research Institute Seoul National University College of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryoung Hee","family":"Nam","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Seoul National University Bundang Hospital  Seongnam Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sun Min","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Seoul National University Bundang Hospital  Seongnam Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Choi","family":"Soo In","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Seoul National University Bundang Hospital  Seongnam Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jung Mogg","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Microbiology Hanyang University School of Medicine  Seoul South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dong Ho","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Seoul National University Bundang Hospital  Seongnam Korea"},{"name":"Department of 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