The sensitivity of H. pylori to tetracycline and amoxicillin is very high and resistance is approximately zero [2]. Our local data in Lebanon show essentially no resistance to tetracycline or amoxicillin and a modest rate of metronidazole resistance, similar to Western countries (Fig 1). The use of these antibiotics to treat H. pylori infection is promising. In addition, we have recently shown in 2 separate randomized controlled trials that the reduced or half-dose of antibiotics (including 500 mg bid of amoxicillin and 250 mg bid of metronidazole) can achieve the same eradication of H. pylori at reduced cost and reduced side effects.