Talarico S, et al. - In patients from the United States Pacific Northwest, the researchers developed and examined a new culture-free assay to identify clarithromycin resistance-conferring mutations to determine the prevalence of H. pylori clarithromycin resistance. Between 2012 and 2014, droplet digital PCR (ddPCR) was utilized to identify the H. pylori 23S rRNA gene, and resistance-conferring mutations, in archived, formalin-fixed, paraffin-embedded (FFPE) gastric tissue and to retrospectively discover the prevalence of clarithromycin-resistant H. pylori among 110 subjects at an academic medical center in the Northwest United States. It was noted that the prevalence of clarithromycin resistance identified in this region exceeds 20%, showing that standard triple therapy should not be the first-line antibiotic treatment for H. pylori infection. For effective H. pylori eradication, culture-free assays for identifying clarithromycin resistance mutations can be conducted on archived tissue samples and will aid in informing tailored treatment.