High rate of post‐therapeutic resistance after failure of macrolide–nitroimidazole triple therapy to cure <i>Helicobacter pylori</i> infection: impact of two second‐line therapies in a randomized study

Omeprazole-bismuth subsalicylate-metron- idazole-tetracycline was superior to omeprazole-clarithromycin-amoxicillin, but both therapies yielded unsatisfactory results. The high rate of post-therapeutic dual resistance has a negative impact on omepraz- ole-clarithromycin-amoxicillin, and probably also on omeprazole-bismuth subsalicylate-metronidazole-tetracycline, and limits the choice for second-line treatment.