Helicobacter pylori (Hp) is the known bacteria living in the human stomach, and the infection rate in China has reached 50-67% (1,2). As the main pathogenic factor of chronic gastritis and peptic ulcer, it is also the Class I pathogenic factor of gastric cancer. Eradication of Hp has a preventive effect on gastric cancer (3,4). Moreover, it can effectively relieve the related symptoms caused by Hp in functional dyspepsia or other stomach diseases, and improve the degree of atrophic gastritis atrophy and intestinal metaplasia.

The eradication of H.pylori infection is based on the empirical antibiotic treatment strategy. The difficulties in the current eradication of Hp include an increasing resistance rate to many routine antibiotics, which leads to a decreasing success rate of Helicobacter pylori eradication year by year. The eradication rate of Hp in previous first-line triple therapy has decreased from more than 90% in the 1990s to less than 60% at present (3,4).

As an infectious disease, the best eradication for H.pylori infection is individualized treatment combined with the sensitivity of H. Pylori related antibiotics. Therefore, if the drug resistance information of antibiotics can be obtained before eradication treatment, no matter the initial treatment, initial treatment failure or the failure of eradication twice (refractory H. Pylori infection), doctors tend to recommend targeted drug selection based on drug sensitivity results, especially for refractory HP infection, family history of gastric cancer, or moderate and severe gastric mucosal atrophy, intestinal metaplasia or dysplasia found in gastroscopy. In this way, not only can satisfactory eradication efficacy be achieved, but also can effectively avoid unreasonable use of antibiotics and reduce the generation of antibiotic resistance.

References：
[1]中华医学会消化病学分会幽门螺杆菌和消化性溃疡学组,全国幽门螺杆菌研究协作组.第五次全国幽门螺杆菌感染处理共识报告[J].中华消化杂志,2017,037(006):364-378.
[2]Xie Y，et al. Long-term follow-up of Helicobacter pylori reinfection and its risk factors after initial eradication: a large-scale multicentre, prospective open cohort, observational study. Emerg Microbes Infect, 2020 Dec;9(1).
[3]Malfertheiner P, Megraud F, O'Morain CA, et al. Management of Helicobacter pylori infection--the Maastricht IV/ Florence Consensus Report. Gut 2012; 61:646.
[4]Chey WD, Leontiadis GI, Howden CW, Moss SF. ACG Clinical Guideline: Treatment of Helicobacter pylori Infection. Am J Gastroenterol 2017; 112:212.