Helicobacter pylori infection is common worldwide. There are many treatment regimens regarding H pylori infection over decades.Due to increasing antibiotic resistance, higher treatment failure rate for H pylori is a growing global concern. The significant number of primary drug resistance to amoxicillin, clarithromycin and metronidazole were reported in America, Europe as well as in Asia. 1 The drug resistance was more common in ASEAN region. 1 Antimicrobial susceptibility testing has been suggested in areas of high antibiotic resistance after the failure of first-line treatment. 2,3 However, this test is not available in most centres particularly in resource limited countries. To solve this problem, treatment protocols with substantially high eradication rates and low antibiotic