title: [Update on the efficacy of triple therapy for Helicobacter pylori infection and clarithromycin resistance rates in Spain (2007-2012)].
abstract: BACKGROUND
  Triple therapy, which remains the standard treatment for Helicobacter pylori infection, should be discouraged when its efficacy is lower than 80% or when clarithromycin resistance rates are above 15-20%.
  
  
  OBJECTIVE
  To update the available evidence on the effectiveness of triple therapy and clarithromycin resistance rates in adults in Spain over the last 6 years.
  
  
  METHODS
  A literature search (2007-2012) was conducted in Medline and the abstracts books of the annual meetings of several Spanish gastroenterological and microbiological congresses. The search terms were « Helicobacter pylori », « Spain » and « clarithromycin ». Studies were selected if they included triple therapy consisting of a proton pump inhibitor with clarithromycin and amoxicillin or if they analyzed H. pylori clarithromycin susceptibility in treatment-naïve patients.
  
  
  RESULTS
  There were five articles and nine abstracts (3147 patients) on triple therapy, which showed a mean cure rate of 70.8% (95% CI = 66-76%). When stratified by the duration of therapy, the mean cure rates were 68.8% (60-76%) for 7-day regimens and 71.76% (68-78%) for 10-day regimens. For clarithromycin resistance rates, four articles and five abstracts (1709 patients) revealed a mean resistance rate of 18.3% (13-22%).
  
  
  CONCLUSIONS
  The efficacy of triple therapy seems to be unacceptable in recent studies conducted in Spain, possibly associated with clarithromcyin resistance rates higher than previously reported.
authors.affiliation: Servicio de Aparato Digestivo, Hospital San Pedro de Alcántara, Cáceres, España. xavi_molina@hotmail.com
authors.forename: Javier
authors.initials: J
authors.lastname: Molina-Infante
authors.forename: Javier P
authors.initials: JP
authors.lastname: Gisbert
mesh_terms: D000658:Amoxicillin / Q000008:administration & dosage; D000900:Anti-Bacterial Agents / Q000494:pharmacology / Q000627:therapeutic use*; D017291:Clarithromycin / Q000494:pharmacology / Q000627:therapeutic use*; D024881:Drug Resistance, Bacterial; D004359:Drug Therapy, Combination; D016481:Helicobacter Infections / Q000188:drug therapy*; D016480:Helicobacter pylori / Q000187:drug effects*; D006801:Humans; D054328:Proton Pump Inhibitors / Q000008:administration & dosage; D013030:Spain; D013997:Time Factors
chemical_list: D000900:Anti-Bacterial Agents; D054328:Proton Pump Inhibitors; D000658:Amoxicillin; D017291:Clarithromycin