title: Eradication Rates of Helicobacter pylori in Korea Over the Past 10 years and Correlation of the Amount of Antibiotics Use: Nationwide Survey.
abstract: BACKGROUND
  The efficacy of proton-pump inhibitor-amoxicillin-clarithromycin therapy for H. pylori eradication has decreased over time.
  
  
  OBJECTIVE
  We assessed the trend of H. pylori eradication rates over the last 10 years and the relationship between the eradication rates and the amount of macrolide antibiotic use in a country with a high prevalence of H. pylori infection.
  
  
  METHODS
  This vast nationwide multicenter study was conducted with 34,139 adults treated for H. pylori infection from January 2001 to December 2010. The defined daily dose per km(2) (DSD) of macrolide antibiotics was calculated (n = 141,019) using the Health Insurance Review & Assessment data base from 2008 to 2010 in the two cities which had the lowest (Jeju city) or highest (Chuncheon city) eradication rate.
  
  
  RESULTS
  The eradication rates of proton-pump inhibitor-amoxicillin-clarithromycin therapy ranged 84.9-87.5% from 2001 to 2007, and those of 2008 to 2010 ranged 80.0-81.4% with a decreasing trend (p < 0.0001). The decreasing trend of eradication rates for the overall first-line therapy was observed only in three of the seven geographic areas in Korea (p < 0.0001). The DSD of macrolide antibiotics was significantly higher in Jeju than Cheunchon city (0.85 vs 0.52, p < 0.0001).
  
  
  CONCLUSIONS
  H. pylori eradication rates with clarithromycin-containing triple therapy in Korea showed a decreasing trend over the past 10 years, although the trend varied among geographic areas. This difference may be associated with the amount of macrolide antibiotic use.
authors.affiliation: Department of Internal Medicine, Hallym University College of Medicine, Seoul, Korea.
authors.forename: Woon Geon
authors.initials: WG
authors.lastname: Shin
authors.affiliation: Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea.
authors.forename: Sang Woo
authors.initials: SW
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, Hallym University College of Medicine, Seoul, Korea.
authors.forename: Gwang Ho
authors.initials: GH
authors.lastname: Baik
authors.affiliation: Department of Internal Medicine, Konyang University College of Medicine, Daejeon, Korea.
authors.forename: Kyu Chan
authors.initials: KC
authors.lastname: Huh
authors.affiliation: Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Sang In
authors.initials: SI
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, Gachon University College of Medicine, Incheon, Korea.
authors.forename: Jun-Won
authors.initials: JW
authors.lastname: Chung
authors.affiliation: Department of Internal Medicine and Institute of Health Sciences, Gyeongsang National University School of Medicine, Jinju, Korea.
authors.forename: Woon Tae
authors.initials: WT
authors.lastname: Jung
authors.affiliation: Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea.
authors.forename: Moo In
authors.initials: MI
authors.lastname: Park
authors.affiliation: Department of Internal Medicine, Ewha Womans University School of Medicine, Seoul, Korea.
authors.forename: Hye-Kyung
authors.initials: HK
authors.lastname: Jung
authors.affiliation: Department of Internal Medicine, Jeju National University School of Medicine, Jeju, Korea.
authors.forename: Heung Up
authors.initials: HU
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Konkuk University School of Medicine, Seoul, Korea.
authors.forename: Jeong Hwan
authors.initials: JH
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Inje University College of Medicine, Busan, Korea.
authors.forename: Sang Young
authors.initials: SY
authors.lastname: Seol
authors.affiliation: Department of Internal Medicine, Chungbuk National University College of Medicine, Cheongju, Korea.
authors.forename: Soon Man
authors.initials: SM
authors.lastname: Yoon
authors.affiliation: Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Korea.
authors.forename: Seong Woo
authors.initials: SW
authors.lastname: Jeon
authors.affiliation: Department of Internal Medicine, Soonchunhyang University College of Medicine, Bucheon, Korea.
authors.forename: Su Jin
authors.initials: SJ
authors.lastname: Hong
authors.affiliation: Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea.
authors.forename: Gwang Ha
authors.initials: GH
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Dong Ho
authors.initials: DH
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, Chonnam National University School of Medicine, Gwangju, Korea.
authors.forename: Hyun Soo
authors.initials: HS
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Wonkwang University School of Medicine, Iksan, Korea.
authors.forename: Suck Chei
authors.initials: SC
authors.lastname: Choi
authors.affiliation: Department of Finance and Information Statistics, Hallym University College of Natural Science, Chuncheon, Korea.
authors.forename: Hee Mo
authors.initials: HM
authors.lastname: Kang
authors.affiliation: Medical Research Collaborating Center, Seoul National University Hospital, Seoul, Korea.|Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Joongyub
authors.initials: J
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Korea.
authors.forename: Jae Gyu
authors.initials: JG
authors.lastname: Kim
authors.affiliation: Department of Medicine, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Jae J
authors.initials: JJ
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D000658:Amoxicillin / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D017291:Clarithromycin / Q000627:therapeutic use; D004363:Drug Utilization; D016481:Helicobacter Infections / Q000188:drug therapy*; D006801:Humans; D007723:Korea; D008297:Male; D008875:Middle Aged; D054328:Proton Pump Inhibitors / Q000627:therapeutic use; D062211:Spatio-Temporal Analysis; D011795:Surveys and Questionnaires; D017211:Treatment Failure; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D054328:Proton Pump Inhibitors; D000658:Amoxicillin; D017291:Clarithromycin
keywords: Helicobacter pylori; antibiotics; treatment failure; trends