The goal of this clinical trial is to learn if the 14-day susceptibility-guided bismuth quadruple therapy works to treat multiple drug resistant Helicobacter pylori (H. pylori) in adults. It will also learn about the adverse effects of bismuth quadruple therapy. The main questions it aims to answer are: * Does 14-day susceptibility-guided bismuth quadruple therapy higher the eradication rate? * What medical problems do participants have when taking 14-day susceptibility-guided bismuth quadruple? Researchers will record 14-day susceptibility-guided bismuth quadruple to see if 14-day susceptibility-guided bismuth quadruple works to treat multiple drug resistant H. pylori. Participants will: * Take susceptibility-guided bismuth quadruple every day for 14 days * Visit the clinic once 4-6 weeks for checkups and tests * Keep a diary of their symptoms during taking susceptibility-guided bismuth quadruple
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The eradication rate of H. pylori
Timeframe: From enrollment to the end of treatment at 6-8 weeks