SUMMARYBackground: Optimal management approach is not well defined for subjects who fail initial first-and second-line Helicobacter pylori eradication attempts and are dealt on a case-by-case basis by the specialists. Aim: To evaluate the efficacy and safety of standard and 'rescue' eradication therapies at primary and secondary care levels. Methods: H. pylori infected dyspepsia patients referred to our C13 urea breath testing laboratory between January 1999 to February 2002 were included. Eradication failure at secondary care level was treated using strategies including antibiotic sensitivity testing and the use of rifabutin-and furazolidone-based therapies. Results: 3280 patients received standard first-line eradication therapy, which was successful in 2530

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SUMMARY BackgroundIt is unclear what impact Helicobacter pylori infection has had on the management of dyspepsia in primary care and to what extent published guidelines on H. pylori are implemented in routine clinical practice.

This study shows a high overall diagnostic yield for SBCE in IDA 71% (n=45). Despite the majority, 53% (n=24), of patients with positive tests receiving specific treatment, 61% (n=17) remained anaemic in the long term. SBCE results were not predictive of long-term outcome even when stratified for a change in management.