The use of daptomycin in continuous renal replacement therapy.

pies remains to be established. Eventually, we recommended a prolonged therapy including PPI (40 mg of omeprazole three times daily) and amoxicillin (1 g three times daily) for 4 weeks, which turned out to be successful, as shown by negative [C]urea breath test, rapid urease test, histopathology, culture and molecular genetic testing 6 weeks after therapy. Multiresistant clinical H. pylori isolates exist in Germany and will probably be increasingly detected in the future. To avoid treatment failures, to minimize the risk of the development of antimicrobial resistance and to reduce costs, we recommend susceptibility testing after the first unsuccessful empirical H. pylori eradication therapy. In patients who have already received multiple antibiotic treatments due to unrelated bacterial infections, susceptibility testing prior to the first eradication attempt may be considered. The presented case demonstrates the risk of upcoming difficult-to-treat H. pylori infections and underlines the need for ongoing studies to keep antibiotic resistance under surveillance.