Korean J Intern Med.  2015 Nov;30(6):801-807. 10.3904/kjim.2015.30.6.801.

Trends in Helicobacter pylori eradication rates by first-line triple therapy and related factors in eradication therapy

• Kim SE
• Park MI
• Park SJ
• Moon W
• Choi YJ
• Cheon JH
• Kwon HJ
• Ku KH
• Yoo CH
• Kim JH
• Lee GW
• Song SE

• KMID: 2381584
• DOI: http://doi.org/10.3904/kjim.2015.30.6.801

Abstract

BACKGROUND/AIMS
Trends in successful eradication of Helicobacter pylori using first-line triple therapy, consisting of a proton pump inhibitor, amoxicillin, and clarithromycin, have been understudied. We evaluated H. pylori eradication rates at a single center over the last 10 years and identified risk factors related to eradication failure.
METHODS
This study included 1,413 patients who were diagnosed with H. pylori infection and received 7 days of triple therapy between January 2003 and December 2012. We investigated H. pylori eradication rates retrospectively with respect to the year of therapy, as well as demographic and clinical factors. H. pylori eradication was confirmed by a 13C-urea breath test or a rapid urease test at least 4 weeks after the completion of triple therapy.
RESULTS
The overall H. pylori eradication rate was 84.9%. Annual eradication rates from 2003 to 2012 were 93.5%, 80.0%, 87.2%, 88.5%, 92.0%, 88.3%, 85.7%, 84.1%, 83.7%, and 78.8%, respectively, by per-protocol analysis. The eradication rate with first-line triple therapy decreased during the last 10 years (p = 0.015). Multivariate analysis showed that female gender (odds ratio [OR], 1.69; 95% confidence interval [CI], 1.12 to 2.55) and smoking (OR, 1.61; 95% CI, 1.05 to 2.47) were associated with the failure of H. pylori eradication therapy.
CONCLUSIONS
The efficacy of first-line triple therapy for H. pylori infection has decreased over the last 10 years, suggesting an increase in antibiotic-resistant H. pylori strains. Thus, other first-line therapies may be necessary for H. pylori eradication in the near future.

Keyword

Helicobacter pylori; Disease eradication; Risk factors

MeSH Terms

Adolescent
Adult
Aged
Aged, 80 and over
Amoxicillin/therapeutic use
Anti-Bacterial Agents/adverse effects/*therapeutic use
Breath Tests
Chi-Square Distribution
Clarithromycin/therapeutic use
Drug Resistance, Bacterial
Drug Therapy, Combination
Female
Helicobacter Infections/diagnosis/*drug therapy/microbiology
Helicobacter pylori/*drug effects
Humans
Linear Models
Logistic Models
Male
Middle Aged
Multivariate Analysis
Odds Ratio
Proton Pump Inhibitors/adverse effects/*therapeutic use
Republic of Korea
Retrospective Studies
Risk Factors
Sex Factors
Smoking/adverse effects
Time Factors
Treatment Failure
Young Adult
Amoxicillin
Anti-Bacterial Agents
Clarithromycin
Proton Pump Inhibitors