title: Delay of second-line eradication therapy for Helicobacter pylori can increase eradication failure.
abstract: OBJECTIVE
  The interval between first-line Helicobacter pylori eradication treatment and second-line treatment may be critical to the second-line therapeutic effect. We attempted to assess the association between the second-line eradication rates and the treatment interval.
  
  
  METHODS
  Data of patients, who were administered the second-line H. pylori eradication regimen at Tokyo Medical Center between 2008 and 2012, were reviewed.
  
  
  RESULTS
  Of the 148 patients enrolled, one patient dropped out. The eradication rates were 88.6% (intention-to-treat [ITT]) and 89.3% (per-protocol [PP]) for early eradication group (eradication interval < 180 days, patients number 132) and 68.8% (ITT and PP) for delayed eradication group (eradication interval ≥ 180 days, patients number 16). The eradication rate in the delayed eradication group was significantly lower than in the early eradication group (P = 0.027 [ITT] and 0.021 [PP]). The eradication interval in the subjects showing eradication failure (124.0 ± 96.8 days, patients number 19) was significantly longer than those showing successful eradication (85.8 ± 56.9 days, patients number 128, P = 0.008).
  
  
  CONCLUSIONS
  Our results suggest that the delay of second-line treatment should be avoided.
authors.affiliation: Division of Gastroenterology, National Hospital Organization Tokyo Medical Center, Tokyo, Japan; Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan.
authors.forename: Toshihiro
authors.initials: T
authors.lastname: Nishizawa
authors.forename: Hidekazu
authors.initials: H
authors.lastname: Suzuki
authors.forename: Masahiko
authors.initials: M
authors.lastname: Takahashi
authors.forename: Masayuki
authors.initials: M
authors.lastname: Suzuki
authors.forename: Toshifumi
authors.initials: T
authors.lastname: Hibi
mesh_terms: D000368:Aged; D000658:Amoxicillin / Q000008:administration & dosage*; D017291:Clarithromycin / Q000008:administration & dosage*; D004359:Drug Therapy, Combination; D005260:Female; D005756:Gastritis / Q000175:diagnosis / Q000188:drug therapy* / Q000382:microbiology*; D016481:Helicobacter Infections; D016480:Helicobacter pylori; D006801:Humans; D008297:Male; D008795:Metronidazole / Q000008:administration & dosage*; D008875:Middle Aged; D054328:Proton Pump Inhibitors / Q000008:administration & dosage*; D012189:Retrospective Studies; D013997:Time Factors; D017211:Treatment Failure; D016896:Treatment Outcome
chemical_list: D054328:Proton Pump Inhibitors; D008795:Metronidazole; D000658:Amoxicillin; D017291:Clarithromycin
keywords: Helicobacter pylori; eradication; interval