幽门螺杆菌(HP)感染是引起慢性胃炎、消化性溃疡、胃癌的重要病因[1]。质子泵抑制剂或铋剂联合二种抗生素的三联疗法被认为是根除HP的一线用药[2]。尽管初次推荐根除方案十分有效,但仍有近20%～30%的患者根除失败[3]。抗生素耐药被认为是根除失败的主要原因,其中克拉霉素和甲硝 Helicobacter pylori (HP) infection is caused by chronic gastritis, peptic ulcer, an important cause of gastric cancer [1]. Proton pump inhibitors or bismuth combined with two antibiotics triple therapy is considered first-line eradication of HP [2]. Although the initial recommended eradication program is very effective, nearly 20% to 30% of patients still have failed to eradication [3]. Antibiotic resistance is considered to be the leading cause of eradication failure, with clarithromycin and metronidazole