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Background/Aims As the prevalence of antibiotic resistance is increasing, the effectiveness of traditional Helicobacter pylori therapies is gradually declining. In particular, the effectiveness of the triple regimen containing clarithromycin (CLA) or metronidazole (MET), proton pump inhibitor, and amoxicillin (AMX) has decreased with a corresponding increase in CLA or MET resistance. In this study, we evaluated the current status of antibiotic resistance of H. pylori in Daegu and Kyungpook province. Methods Patients who revealed H. pylori infection were prospectively enrolled from June 2016 to April 2019 in Daegu and Kyungpook province. The patients' clinical data and H. pylori culture and antibiotic susceptibility tests were evaluated. For antibiotic susceptibility of H. pylori, minimum inhibitory concentrations (MICs) of AMX, CLA, MET, tetracycline (TC), and levofloxacin (LEV) were determined according to the agar dilution method. Results Of 101 consecutive patients, the H. pylori strains of 82 patients (81.2%) were successfully cultured. Total antibiotic resistance to AMX, CLA, MET, TC, and LEV was 7.3%, 36.6%, 35.4%, 3.9% and 32.9%. The prevalence of antibiotic resistance based on previous eradication showed in Fig. 1. In these patients, 27 patients' H. pylori strains (32.9%) showed two or more antibiotic resistance. The dual and multi drug resistance of these patients based on previous eradication history showed in Tables 1 and 2. The prevalence of antibiotic resistance was significant different between primary resistance and failure of 1st or more eradication group (p<0.001). Conclusions Primary antibiotic resistance in Daegu and Kyungpook province was lower compared to other area in Korea, especially Seoul and Gyeonggi province. However, the multi drug resistance was the main cause of in failure of H. pylori eradication. [ABSTRACT FROM AUTHOR]