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As antibiotic resistance to Helicobacter pylori increases, initial treatment failure is becoming more common, and the optimal salvage therapy for these patients remains unclear. Investigators in China evaluated the efficacy of four bismuth-based therapies in 424 patients with H. pylori infection who failed initial triple therapy (metronidazole with clarithromycin or amoxicillin, or both). Nearly half of patients failed an additional levofloxacin-containing therapy. Patients were randomized to a 2-week regimen of lansoprazole (30 mg) and bismuth potassium citrate (220 mg) twice daily, and one of the following:
Tetracycline (500 mg) and metronidazole (400 mg) 4 times daily (LBTM)
Tetracycline (500 mg) 4 times daily and furazolidone (100 mg) 3 t…