Optimizing clarithromycin-containing therapy for Helicobacter pylori in the era of antibiotic resistance

Figure 1 Intention-to-treat cure rates of concomitant therapy over the last three years in studies conducted in Latin America, Asia and Europe, broken down by the duration of therapy. Studies with Intention-to-treat (ITT) < 85% are grey marked.

Figure 2 Forest plot comparing sequential and concomitant therapy with a similar duration[72].

Figure 3 Regionalized therapeutic algorithm for Helicobacter pylori infection, based on clarithromycin and metronidazole resistance patterns. ¹Use conditioned to the rate of dual-resistant strains. Sequential, hybrid and concomitant therapies are expected to fail if the rate of dual clarithromycin- and metronidazole-resistant strains in > 5%, > 9% and > 15%, respectively; ²Use if eradication rates > 90% have been documented.