title: Ten-year trend of the cumulative Helicobacter pylori eradication rate for the 'Japanese eradication strategy'.
abstract: OBJECTIVE
  In Japan, a systematic eradication strategy for Helicobacter pylori has been constructed, and consists of a proton pump inhibitor/amoxicillin and clarithromycin (PPI/AC) therapy as the first-line regimen and proton pump inhibitor/amoxicillin and metronidazole (PPI/AM) therapy as the second-line regimen. The cumulative rate of H. pylori eradication has not been reported. Therefore, we investigated the annual and cumulative eradication rate to verify the efficacy of the 'Japanese eradication strategy'.
  
  
  METHODS
  Patients who received first-line PPI/AC therapy and, if necessary, second-line PPI/AM therapy between 2000 and 2009 were retrospectively analyzed. The annual cumulative eradication rate was calculated. Data were subjected to intention-to-treat analysis.
  
  
  RESULTS
  PPI/AC was administered to 1973 patients (male n = 1,162, female n = 811; mean age: 55.8 years, range: 15–87), and 250 patients received PPI/ AM. The eradication rate for the PPI/AC regimen was 65.3%, and it gradually but significantly decreased over 10 years (p < 0.05). For the PPI/AM regimen, the eradication rate was 84.0%, with no change in the annual eradication rate. The cumulative eradication rates were 76.0% in intention-to-treat analysis and 98.4% in per-protocol analysis, respectively, which provided a consistent annual eradication rate without decreases in effectiveness.
  
  
  CONCLUSIONS
  Although the eradication rate for the first-line PPI/AC regimen decreased over time, the 'Japanese eradication strategy' provided a sufficient eradication rate.
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Sasaki
authors.forename: Akihito
authors.initials: A
authors.lastname: Nagahara
authors.forename: Mariko
authors.initials: M
authors.lastname: Hojo
authors.forename: Daisuke
authors.initials: D
authors.lastname: Asaoka
authors.forename: Kenshi
authors.initials: K
authors.lastname: Matsumoto
authors.forename: Taro
authors.initials: T
authors.lastname: Osada
authors.forename: Sumio
authors.initials: S
authors.lastname: Watanabe
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000658:Amoxicillin / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D017291:Clarithromycin / Q000627:therapeutic use; D060740:Disease Eradication / Q000639:trends*; D004359:Drug Therapy, Combination; D004381:Duodenal Ulcer / Q000188:drug therapy / Q000382:microbiology; D005260:Female; D005756:Gastritis / Q000188:drug therapy / Q000382:microbiology; D016481:Helicobacter Infections / Q000150:complications / Q000517:prevention & control*; D016480:Helicobacter pylori; D006801:Humans; D057194:Intention to Treat Analysis; D007564:Japan; D008297:Male; D008795:Metronidazole / Q000627:therapeutic use; D008875:Middle Aged; D054328:Proton Pump Inhibitors / Q000627:therapeutic use*; D012189:Retrospective Studies; D013276:Stomach Ulcer / Q000188:drug therapy / Q000382:microbiology; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D054328:Proton Pump Inhibitors; D008795:Metronidazole; D000658:Amoxicillin; D017291:Clarithromycin