title: Seven-day triple therapy is a better choice for Helicobacter pylori eradication in regions with low antibiotic resistance.
abstract: OBJECTIVE
  To investigate whether 7-d triple therapies are still valid in populations with low levels of resistance.
  
  
  METHODS
  A total of 1106 Helicobacter pylori (H. pylori)-positive patients were divided into three groups, each of which received one type of 7-d triple therapy. Therapeutic outcomes of the patients were assessed by the (13)C-urea breath test at 8 wk after treatment. The susceptibility of H. pylori to antibiotics was determined by an agar-dilution method. Data analysis was performed by χ(2) tests.
  
  
  RESULTS
  The eradication rates in groups A, B and C were 90.71% (332/366), 90.46% (313/346) and 90.87% (189/208), respectively (P = 0.986). The resistance rates were 8.91% for clarithromycin, 14.78% for levofloxacin and 0% for amoxicillin. The eradication rate was significantly different between clarithromycin- and levofloxacin-resistant patients (P < 0.05) in group A. Patients whose treatment failed in group A also had a higher clarithromycin resistance rate than did successive patients (P = 0.034). However, levofloxacin resistance had no obvious influence on the eradication rate. Furthermore, three main antibiotics (clarithromycin, levofloxacin and amoxicillin) had lower DID (defined daily dose per 1000 inhabitants per day) in this city.
  
  
  CONCLUSIONS
  Clarithromycin resistance is the main reason for the failure of 7-d triple therapy. In populations with low levels of resistance, a 7-d triple therapy is a viable choice. The choice of therapy should not be influenced by conditions in high antibiotic resistance regions.
authors.affiliation: Yue-Feng Tong, Jun Lv, Li-Yuan Ying, Fang Xu, Bo Qin, Ming-Tong Chen, Department of Gastroenterology, The First People's Hospital of Yongkang, Yongkang 321300, Zhejiang Province, China.
authors.forename: Yue-Feng
authors.initials: YF
authors.lastname: Tong
authors.affiliation: Yue-Feng Tong, Jun Lv, Li-Yuan Ying, Fang Xu, Bo Qin, Ming-Tong Chen, Department of Gastroenterology, The First People's Hospital of Yongkang, Yongkang 321300, Zhejiang Province, China.
authors.forename: Jun
authors.initials: J
authors.lastname: Lv
authors.affiliation: Yue-Feng Tong, Jun Lv, Li-Yuan Ying, Fang Xu, Bo Qin, Ming-Tong Chen, Department of Gastroenterology, The First People's Hospital of Yongkang, Yongkang 321300, Zhejiang Province, China.
authors.forename: Li-Yuan
authors.initials: LY
authors.lastname: Ying
authors.affiliation: Yue-Feng Tong, Jun Lv, Li-Yuan Ying, Fang Xu, Bo Qin, Ming-Tong Chen, Department of Gastroenterology, The First People's Hospital of Yongkang, Yongkang 321300, Zhejiang Province, China.
authors.forename: Fang
authors.initials: F
authors.lastname: Xu
authors.affiliation: Yue-Feng Tong, Jun Lv, Li-Yuan Ying, Fang Xu, Bo Qin, Ming-Tong Chen, Department of Gastroenterology, The First People's Hospital of Yongkang, Yongkang 321300, Zhejiang Province, China.
authors.forename: Bo
authors.initials: B
authors.lastname: Qin
authors.affiliation: Yue-Feng Tong, Jun Lv, Li-Yuan Ying, Fang Xu, Bo Qin, Ming-Tong Chen, Department of Gastroenterology, The First People's Hospital of Yongkang, Yongkang 321300, Zhejiang Province, China.
authors.forename: Ming-Tong
authors.initials: MT
authors.lastname: Chen
authors.affiliation: Yue-Feng Tong, Jun Lv, Li-Yuan Ying, Fang Xu, Bo Qin, Ming-Tong Chen, Department of Gastroenterology, The First People's Hospital of Yongkang, Yongkang 321300, Zhejiang Province, China.
authors.forename: Fei
authors.initials: F
authors.lastname: Meng
authors.affiliation: Yue-Feng Tong, Jun Lv, Li-Yuan Ying, Fang Xu, Bo Qin, Ming-Tong Chen, Department of Gastroenterology, The First People's Hospital of Yongkang, Yongkang 321300, Zhejiang Province, China.
authors.forename: Miao-Ying
authors.initials: MY
authors.lastname: Tu
authors.affiliation: Yue-Feng Tong, Jun Lv, Li-Yuan Ying, Fang Xu, Bo Qin, Ming-Tong Chen, Department of Gastroenterology, The First People's Hospital of Yongkang, Yongkang 321300, Zhejiang Province, China.
authors.forename: Ning-Min
authors.initials: NM
authors.lastname: Yang
authors.affiliation: Yue-Feng Tong, Jun Lv, Li-Yuan Ying, Fang Xu, Bo Qin, Ming-Tong Chen, Department of Gastroenterology, The First People's Hospital of Yongkang, Yongkang 321300, Zhejiang Province, China.
authors.forename: You-Ming
authors.initials: YM
authors.lastname: Li
authors.affiliation: Yue-Feng Tong, Jun Lv, Li-Yuan Ying, Fang Xu, Bo Qin, Ming-Tong Chen, Department of Gastroenterology, The First People's Hospital of Yongkang, Yongkang 321300, Zhejiang Province, China.
authors.forename: Jian-Zhong
authors.initials: JZ
authors.lastname: Zhang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D001944:Breath Tests; D002648:Child; D002675:Child, Preschool; D002681:China; D004334:Drug Administration Schedule; 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* / Q000302:isolation & purification; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D018579:Patient Selection; D054328:Proton Pump Inhibitors / Q000008:administration & dosage*; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D054328:Proton Pump Inhibitors
keywords: Clarithromycin resistance; Eradication rate; Helicobacter pylori; Levofloxacin resistance; Seven-day triple therapy