title: Trends in Helicobacter pylori eradication rates by first-line triple therapy and related factors in eradication therapy.
abstract: OBJECTIVE
  Trends in successful eradication of Helicobacter pylori using first-line triple therapy, consisting of a proton pump inhibitor, amoxicillin, and clarithromycin, have been understudied. We evaluated H. pylori eradication rates at a single center over the last 10 years and identified risk factors related to eradication failure.
  
  
  METHODS
  This study included 1,413 patients who were diagnosed with H. pylori infection and received 7 days of triple therapy between January 2003 and December 2012. We investigated H. pylori eradication rates retrospectively with respect to the year of therapy, as well as demographic and clinical factors. H. pylori eradication was confirmed by a (13)C-urea breath test or a rapid urease test at least 4 weeks after the completion of triple therapy.
  
  
  RESULTS
  The overall H. pylori eradication rate was 84.9%. Annual eradication rates from 2003 to 2012 were 93.5%, 80.0%, 87.2%, 88.5%, 92.0%, 88.3%, 85.7%, 84.1%, 83.7%, and 78.8%, respectively, by per-protocol analysis. The eradication rate with first-line triple therapy decreased during the last 10 years (p = 0.015). Multivariate analysis showed that female gender (odds ratio [OR], 1.69; 95% confidence interval [CI], 1.12 to 2.55) and smoking (OR, 1.61; 95% CI, 1.05 to 2.47) were associated with the failure of H. pylori eradication therapy.
  
  
  CONCLUSIONS
  The efficacy of first-line triple therapy for H. pylori infection has decreased over the last 10 years, suggesting an increase in antibiotic-resistant H. pylori strains. Thus, other first-line therapies may be necessary for H. pylori eradication in the near future.
authors.affiliation: Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea.
authors.forename: Sung Eun
authors.initials: SE
authors.lastname: Kim
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, Kosin University College of Medicine, Busan, Korea.
authors.forename: Seun Ja
authors.initials: SJ
authors.lastname: Park
authors.affiliation: Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea.
authors.forename: Won
authors.initials: W
authors.lastname: Moon
authors.affiliation: Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea.
authors.forename: Youn Jung
authors.initials: YJ
authors.lastname: Choi
authors.affiliation: Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea.
authors.forename: Ji Hyun
authors.initials: JH
authors.lastname: Cheon
authors.affiliation: Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea.
authors.forename: Hye Jung
authors.initials: HJ
authors.lastname: Kwon
authors.affiliation: Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea.
authors.forename: Ki Hwan
authors.initials: KH
authors.lastname: Ku
authors.affiliation: Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea.
authors.forename: Chang Hun
authors.initials: CH
authors.lastname: Yoo
authors.affiliation: Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea.
authors.forename: Jae Hyun
authors.initials: JH
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea.
authors.forename: Gyu Won
authors.initials: GW
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea.
authors.forename: Sung Eun
authors.initials: SE
authors.lastname: Song
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000658:Amoxicillin / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001944:Breath Tests; D016009:Chi-Square Distribution; D017291:Clarithromycin / Q000627:therapeutic use; D024881:Drug Resistance, Bacterial; D004359:Drug Therapy, Combination; D005260:Female; D016481:Helicobacter Infections / Q000175:diagnosis / Q000188:drug therapy* / Q000382:microbiology; D016480:Helicobacter pylori / Q000187:drug effects*; D006801:Humans; D016014:Linear Models; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D054328:Proton Pump Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D056910:Republic of Korea; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D012907:Smoking / Q000009:adverse effects; D013997:Time Factors; D017211:Treatment Failure; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D054328:Proton Pump Inhibitors; D000658:Amoxicillin; D017291:Clarithromycin
keywords: Disease eradication; Helicobacter pylori; Risk factors