{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,9]],"date-time":"2026-01-09T14:55:28Z","timestamp":1767970528403,"version":"3.49.0"},"reference-count":30,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2022,7,20]],"date-time":"2022-07-20T00:00:00Z","timestamp":1658275200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100004663","name":"Ministry of Science and Technology, Taiwan","doi-asserted-by":"publisher","award":["MOST109\u20102314\u2010B039\u2010053"],"award-info":[{"award-number":["MOST109\u20102314\u2010B039\u2010053"]}],"id":[{"id":"10.13039\/501100004663","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004663","name":"Ministry of Science and Technology, Taiwan","doi-asserted-by":"publisher","award":["MOST110\u20102314\u2010B039\u2010045"],"award-info":[{"award-number":["MOST110\u20102314\u2010B039\u2010045"]}],"id":[{"id":"10.13039\/501100004663","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100020872","name":"Tainan Municipal An-Nan Hospital","doi-asserted-by":"publisher","award":["ANHRF 109\u201013"],"award-info":[{"award-number":["ANHRF 109\u201013"]}],"id":[{"id":"10.13039\/501100020872","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100020872","name":"Tainan Municipal An-Nan Hospital","doi-asserted-by":"publisher","award":["ANHRF 109\u201038"],"award-info":[{"award-number":["ANHRF 109\u201038"]}],"id":[{"id":"10.13039\/501100020872","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100020872","name":"Tainan Municipal An-Nan Hospital","doi-asserted-by":"publisher","award":["ANHRF 110\u201017"],"award-info":[{"award-number":["ANHRF 110\u201017"]}],"id":[{"id":"10.13039\/501100020872","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100020872","name":"Tainan Municipal An-Nan Hospital","doi-asserted-by":"publisher","award":["ANHRF 110\u201043"],"award-info":[{"award-number":["ANHRF 110\u201043"]}],"id":[{"id":"10.13039\/501100020872","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100011645","name":"Kaohsiung Medical University Chung-Ho Memorial Hospital","doi-asserted-by":"publisher","award":["KMUH108-8R01"],"award-info":[{"award-number":["KMUH108-8R01"]}],"id":[{"id":"10.13039\/501100011645","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":[[2022,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and Aim<\/jats:title><jats:p>Most consensuses recommend culture\u2010guided therapy as third\u2010line <jats:styled-content style=\"fixed-case\"><jats:italic>Helicobacter pylori<\/jats:italic><\/jats:styled-content> treatment. This study aimed to investigate the efficacies of culture\u2010guided therapy and empirical therapy with high\u2010dose proton pump inhibitor (PPI) in the <jats:styled-content style=\"fixed-case\"><jats:italic>H. pylori<\/jats:italic><\/jats:styled-content> third\u2010line treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Between August 2012 and October 2021, <jats:styled-content style=\"fixed-case\"><jats:italic>H. pylori<\/jats:italic><\/jats:styled-content>\u2010infected patients with at least two failed eradication attempts received anti\u2010<jats:styled-content style=\"fixed-case\"><jats:italic>H. pylori<\/jats:italic><\/jats:styled-content> therapy according to the results of antimicrobial sensitivity tests plus high\u2010dose rabeprazole and\/or bismuth. They were categorized into three groups: patients who had positive results of culture with equal to or more than three susceptible antibiotics were treated by culture\u2010guided non\u2010bismuth quadruple therapy, patients who had positive results of culture with one or two susceptible antibiotics were treated by culture\u2010guided bismuth\u2010containing therapy, and patients who had a negative result of culture were treated by an empirical therapy with high\u2010dose rabeprazole plus amoxicillin, tetracycline and levofloxacin. A post\u2010treatment assessment was conducted at week 8.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We recruited 126 patients. The eradication rates of culture\u2010guided non\u2010bismuth quadruple therapy (<jats:italic>n<\/jats:italic>\u00a0=\u00a050), culture\u2010guided bismuth\u2010containing therapy (<jats:italic>n<\/jats:italic>\u00a0=\u00a046) and empirical therapy (<jats:italic>n<\/jats:italic>\u00a0=\u00a030) were 84.0%, 87.0%, and 66.7% (95% confidence interval: 73.8\u201394.2%, 77.3\u201396.7%, and 49.8\u201383.6%), respectively. Overall, culture\u2010guided therapy achieved a higher eradication rate than empirical therapy (85.4% <jats:italic>vs<\/jats:italic> 66.7%; 95% confidence interval, 0.4% to 37.0%, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.022).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Culture\u2010guided therapy with high\u2010dose PPI achieves a higher eradication rate than empirical therapy with high\u2010dose PPI in the third\u2010line treatment of <jats:styled-content style=\"fixed-case\"><jats:italic>H. pylori<\/jats:italic><\/jats:styled-content> infection. The eradication rate of rescue therapy with bismuth plus two susceptible antibiotics is not inferior to that with three susceptible antibiotics.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jgh.15942","type":"journal-article","created":{"date-parts":[[2022,7,11]],"date-time":"2022-07-11T14:59:27Z","timestamp":1657551567000},"page":"1928-1934","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["The efficacy of culture\u2010guided <i>versus<\/i> empirical therapy with high\u2010dose proton pump inhibitor as third\u2010line treatment of <scp><i>Helicobacter pylori<\/i><\/scp> infection: A real\u2010world clinical experience"],"prefix":"10.1111","volume":"37","author":[{"given":"Jiunn\u2010Wei","family":"Wang","sequence":"first","affiliation":[{"name":"Graduate Institute of Clinical Medicine, College of Medicine Kaohsiung Medical University  Kaohsiung Taiwan"},{"name":"Department of Medicine, College of Medicine Kaohsiung Medical University  Kaohsiung City Taiwan"},{"name":"Division of Gastroenterology, Department of Internal Medicine Kaohsiung Medical University Hospital  Kaohsiung Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3905-4674","authenticated-orcid":false,"given":"Ping\u2010I","family":"Hsu","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Department of Internal Medicine An Nan Hospital, China Medical University  Tainan Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ming\u2010Hong","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Microbiology and Immunology, School of Medicine, College of Medicine Kaohsiung Medical University  Kaohsiung Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John","family":"Kao","sequence":"additional","affiliation":[{"name":"Internal Medicine University of Michigan Health System  Ann Arbor Michigan USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Feng\u2010Woei","family":"Tsay","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Department of Internal Medicine Kaohsiung Veterans General Hospital  Kaohsiung Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"I\u2010Ting","family":"Wu","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Department of Internal Medicine An Nan Hospital, China Medical University  Tainan Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chang\u2010Bih","family":"Shie","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Department of Internal Medicine An Nan Hospital, China Medical University  Tainan Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Deng\u2010Chyang","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Medicine, College of Medicine Kaohsiung Medical University  Kaohsiung City Taiwan"},{"name":"Division of Gastroenterology, Department of Internal Medicine Kaohsiung Medical University Hospital  Kaohsiung Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2022,7,20]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2017.04.022"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMcp1001110"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2014.24"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2016-312288"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2016.563"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/hel.12368"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.3109\/00365521.2015.1037345"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkp034"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2018.06.047"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2044.1981.tb08683.x"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v21.i37.10669"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1155\/2015\/163960"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.2147\/IDR.S185511"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40364-017-0103-x"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.2133\/dmpk.20.153"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1248\/bpb.25.923"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.2006.00717.x"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clpt.2004.05.002"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clpt.2004.06.008"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1086\/516284"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2014.10.036"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1177\/1756283X15621229"},{"key":"e_1_2_6_24_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.2006.01109.x"},{"key":"e_1_2_6_25_1","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000002698"},{"key":"e_1_2_6_26_1","doi-asserted-by":"publisher","DOI":"10.1177\/1756284819874922"},{"key":"e_1_2_6_27_1","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkv155"},{"key":"e_1_2_6_28_1","doi-asserted-by":"publisher","DOI":"10.3390\/antibiotics9030121"},{"key":"e_1_2_6_29_1","doi-asserted-by":"publisher","DOI":"10.1177\/1756284820976990"},{"key":"e_1_2_6_30_1","doi-asserted-by":"publisher","DOI":"10.1039\/c2mt00180b"},{"key":"e_1_2_6_31_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2015-311019"}],"container-title":["Journal of Gastroenterology and Hepatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jgh.15942","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/jgh.15942","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jgh.15942","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,22]],"date-time":"2023-08-22T03:38:58Z","timestamp":1692675538000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jgh.15942"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,7,20]]},"references-count":30,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2022,10]]}},"alternative-id":["10.1111\/jgh.15942"],"URL":"https:\/\/doi.org\/10.1111\/jgh.15942","archive":["Portico"],"relation":{},"ISSN":["0815-9319","1440-1746"],"issn-type":[{"value":"0815-9319","type":"print"},{"value":"1440-1746","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,7,20]]},"assertion":[{"value":"2022-05-08","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-07-03","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-07-20","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}