Changes in 12-Year First-Line Eradication Rate of Helicobacter pylori Based on Triple Therapy with Proton Pump Inhibitor, Amoxicillin and Clarithromycin

• Published in: Journal of Clinical Biochemistry and Nutrition Vol. 47; no. 1; pp. 53 - 58
• Main Authors: Sasaki, Makoto, Ogasawara, Naotaka, Utsumi, Keiko, Kawamura, Naohiko, Kamiya, Tskeshi, Kataoka, Hiromi, Tanida, Satoshi, Mizoshita, Tsutomu, Kasugai, Kunio, Joh, Takashi
• Format: Journal Article
• Language: English
• Published: Japan SOCIETY FOR FREE RADICAL RESEARCH JAPAN 01-07-2010; Japan Science and Technology Agency; the Society for Free Radical Research Japan
• Subjects: amoxicillin; clarithromycin resistance; Helicobacter pylori; Original; proton pump inhibitor; triple therapy; amoxicillin; Helicobacter pylori; triple therapy; proton pump inhibitor; clarithromycin resistance
• ISSN: 0912-0009; 1880-5086
• DOI: 10.3164/jcbn.10-10

A triple therapy based on a proton pump inhibitor (PPI), amoxicillin (AMPC), and clarithromycin (CAM) is recommended as a first-line therapy for Helicobacter pylori (H. pylori) eradication and is widely used in Japan. However, a decline in eradication rate associated with an increase in prevalence of CAM resistance is viewed as a problem. We investigated CAM resistance and eradication rates over time retrospectively in 750 patients who had undergone the triple therapy as first-line eradication therapy at Nagoya City University Hospital from 1995 to 2008, divided into four terms (Term 1: 1997–2000, Term 2: 2001–2003, Term 3: 2004–2006, Term 4: 2007–2008). Primary resistance to CAM rose significantly over time from 8.7% to 23.5%, 26.7% and 34.5% while the eradication rate decreased significantly from 90.6% to 80.2%, 76.0% and 74.8%. Based on the PPI type, significant declines in eradication rates were observed with omeprazole or lansoprazole, but not with rabeprazole. A decrease in the H. pylori eradication rate after triple therapy using a PPI + AMPC + CAM has been acknowledged, and an increase in CAM resistance is considered to be a factor. From now on, a first-line eradication regimen that results in a higher eradication rate ought to be investigated.