Eradication rates of 70-85% mean that one patient in five or more may still be infected after treatment. A test of cure is the only way to know, and a false negative is common if the proton pump inhibitor has not been stopped.
- Test for cure with a urea breath test or stool antigen at least four weeks after antibiotics end
- Stop the PPI two weeks before the test
- Do not use serology to confirm cure — antibodies persist
- After two failed regimens, ask for culture or molecular susceptibility testing
Why it matters
Untested treatment failure silently drives resistance and repeated empirical courses.
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