Liou JM, Chen CC, Chang CM, et al. - Researchers investigated the short-term and long-term effects of Helicobacter pylori eradication with first-line treatment [triple therapy for 14 days (T14; lansoprazole 30 mg, amoxicillin 1 g, and clarithromycin 500 mg, all given twice daily), or concomitant therapy for 10 days (C10; lansoprazole 30 mg, amoxicillin 1 g, clarithromycin 500 mg, and metronidazole 500 mg, all given twice daily), or bismuth quadruple therapy for 10 days (BQ10; bismuth tripotassium dicitrate 300 mg four times a day, lansoprazole 30 mg twice daily, tetracycline 500 mg four times a day, and metronidazole 500 mg three times a day)] on the gut microbiota, antibiotic resistance, and metabolic parameters. In this multicentre, open-label, randomized trial done at nine medical centres in Taiwan, they assigned 1,620 adult patients (> 20 years) with documented H pylori infection (1:1:1, with block sizes of six) to receive T14, C10, or BQ10. Outcomes revealed insignificant disruption of the microbiota, no influence on antibiotic resistance of E coli, and some positive effects on metabolic parameters following eradication of H pylori infection. Collectively, these results illustrate the long-term safety of H pylori eradication treatment.