[Clinical characteristic analysis of refractory <i>Helicobacter pylori</i> infection of 637 patients].

<b>Objective:</b> To evaluate the effectiveness of empiric eradication therapy recommendations and medication principles for refractory infections based on the 2022 <i>Helicobacter pylori</i> (<i>H. pylori</i>) infection treatment guidelines in China in clinical practice. <b>Methods:</b> A retrospective analysis was conducted to evaluate the eradication efficacy of <i>H. pylori</i> and the safety and treatment compliance among of 637 patients with refractory <i>H. pylori</i> infection in our center over the past 10 years. Risk factors affecting efficacy of <i>H. pylori</i> eradication were evaluated. <b>Results:</b> The overall eradication rate, incidence of adverse reactions and medication percentage of 14-day bismuth quadruple therapy were 92.3%, 40.3% and 92.2%, respectively. The eradication rate, incidence of adverse reactions, and proportion of administered treatments were as follows: 87.3%, 36.4% and 92.7% for amoxicillin+metronidazole; 91.1%, 39.2% and 93.7% for amoxicillin+tetracycline; 92.9%, 23.8% and 94.0% for amoxicillin+furazolidone; 92.1%, 47.1% and 90.0% for tetracycline+metronidazole; 94.5%, 41.7% and 92.0% for tetracycline+furazolidone, and 91.3%, 46.3% and 92.5% for furazolidone+metronidazole. Poor compliance was a risk factor for the failure of eradication therapy (94.7% vs. 64.0%, <i>P</i><0.05). There was no statistically significant difference (<i>P</i>>0.05) in the eradication rate among patients in terms of sex, age, body mass index, smoking status, alcohol consumption, previous eradication frequency, eradication interval, or eradication regimens. <b>Conclusion:</b> The empirical treatment regimens and medication principles recommended in the 2022 <i>H. pylori</i> infection treatment guidelines in China achieve good eradication efficacy, safety, and compliance.