Although this difference did not reach statistical significance, the small sample size of this study does not preclude the possibility of a small but clinically significant difference in efficacy between the regimens. 3.3. “Rescue” Regimen after PPI-Clarithromycin-Nitroimidazole Failure As previously mentioned, acquired bacterial resistance to metronidazole or clarithromycin results primarily from the previous treatment failure [ 132 ], and therefore the first choice probably should not be a regimen that combines these two antibiotics in the same regimen [ 30 , 31 , 133 ].
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