title: Changes in 12-Year First-Line Eradication Rate of Helicobacter pylori Based on Triple Therapy with Proton Pump Inhibitor, Amoxicillin and Clarithromycin.
abstract: A triple therapy based on a proton pump inhibitor (PPI), amoxicillin (AMPC), and clarithromycin (CAM) is recommended as a first-line therapy for Helicobacter pylori (H. pylori) eradication and is widely used in Japan. However, a decline in eradication rate associated with an increase in prevalence of CAM resistance is viewed as a problem. We investigated CAM resistance and eradication rates over time retrospectively in 750 patients who had undergone the triple therapy as first-line eradication therapy at Nagoya City University Hospital from 1995 to 2008, divided into four terms (Term 1: 1997-2000, Term 2: 2001-2003, Term 3: 2004-2006, Term 4: 2007-2008). Primary resistance to CAM rose significantly over time from 8.7% to 23.5%, 26.7% and 34.5% while the eradication rate decreased significantly from 90.6% to 80.2%, 76.0% and 74.8%. Based on the PPI type, significant declines in eradication rates were observed with omeprazole or lansoprazole, but not with rabeprazole. A decrease in the H. pylori eradication rate after triple therapy using a PPI + AMPC + CAM has been acknowledged, and an increase in CAM resistance is considered to be a factor. From now on, a first-line eradication regimen that results in a higher eradication rate ought to be investigated.
authors.affiliation: Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi Mizuho, Nagoya 467-8601, Japan.
authors.forename: Makoto
authors.initials: M
authors.lastname: Sasaki
authors.forename: Naotaka
authors.initials: N
authors.lastname: Ogasawara
authors.forename: Keiko
authors.initials: K
authors.lastname: Utsumi
authors.forename: Naohiko
authors.initials: N
authors.lastname: Kawamura
authors.forename: Tskeshi
authors.initials: T
authors.lastname: Kamiya
authors.forename: Hiromi
authors.initials: H
authors.lastname: Kataoka
authors.forename: Satoshi
authors.initials: S
authors.lastname: Tanida
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Mizoshita
authors.forename: Kunio
authors.initials: K
authors.lastname: Kasugai
authors.forename: Takashi
authors.initials: T
authors.lastname: Joh