An additional consideration is that primary resistance to Clarithromycine increases dramatically after the failure of standard triple therapy secondary resistance 56, 57. Consequently, under these circumstances, Clarithromycine can not be used in any rescue therapy after it has already been used as part of the initial treatment 12, 58.
Adicionalmente a la resistencia primaria a claritromicina, esta se aumenta dramáticamente, cuando la TTE fracasa resistencia secundaria 56, 57, por lo cual en el tratamiento de rescate, no debe incluirse claritromicina si esta fue utilizada en el tratamiento inicial 12, 58.