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Multicenter Study
, 24 (5), e12646

Online Registry for Nationwide Database of Helicobacter Pylori Eradication in Korea: Correlation of Antibiotic Use Density With Eradication Success

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Multicenter Study

Online Registry for Nationwide Database of Helicobacter Pylori Eradication in Korea: Correlation of Antibiotic Use Density With Eradication Success

Beom Jin Kim et al. Helicobacter.

Abstract

Background: The Helicobacter pylori eradication rate has decreased with increasing antibiotic resistance. We conducted a prospective, nationwide, multicenter registry study to monitor the real status of H. pylori eradication therapy and to investigate the association between eradication success and antibiotic use density in Korea.

Materials and methods: We enrolled 9318 patients undergoing H. pylori eradication therapy from 37 hospitals through "on-line database registry" from October 2010 to July 2015. Demographic data, detection methods, treatment indications, regimens, durations, compliance, adverse events, and eradication results were collected. The use of all commercially available eradication antibiotics was analyzed through the Korean National Health Insurance data of the Health Insurance Review and Assessment Service. The defined daily dose of antibiotics was used to standardize drug use comparisons.

Results: Finally, 6738 patients were analyzed. The overall eradication rate of first-line therapy was 71.8%. The eradication success rates were 71.7%, 86.9%, and 74.0% for standard triple therapy for 7 days, quadruple therapy, and concomitant therapy, respectively. The eradication success rate in naive patients was higher than that in those who previously underwent H. pylori eradication. Eradication success was significantly associated with younger age, female sex, and high compliance. Regional differences in eradication rates were observed. The yearly use density of clarithromycin increased statistically in seven regions across the country from 2010 to 2015. The yearly use density of amoxicillin in the Gyeongsang and Chungcheong areas was significantly increased (P < .01), whereas that of other macrolides was significantly lower in the Gyeonggi area than in other areas (P = .01). The overall use of eradication antibiotics has increased while the eradication rate steadily decreased for 5 years. However, there was no significant correlation between antibiotic use density and eradication.

Conclusion: There was no relationship between the eradication rate and antibiotic use density in Korea.

Keywords: Helicobacter pylori; antibiotic use; eradication success; first-line therapy; online registry.

Figures

Figure 1
Figure 1
Helicobacter pylori eradication in first‐line and second‐line therapy. A total of 6738 patients participated in the study. Overall eradication rates with first‐line and second‐line therapy were 71.8% and 85.8%, respectively
Figure 2
Figure 2
Overall Helicobacter pylori eradication rate and antibiotic use according to seven regions in Korea. Eradication rate is represented as a percentage; antibiotic use (clarithromycin/other macrolide/ amoxicillin) is represented as defined daily dose per 1000 habitants per day. The overall eradication rate in seven regions in Korea was 71.8%. Gyeongsang province showed the highest eradication rate with first‐line therapy, whereas Chungcheong province had the lowest eradication rate. Overall use of clarithromycin, other macrolide, and amoxicillin varied among regions. In particular, Seoul showed the highest use of clarithromycin among the seven regions
Figure 3
Figure 3
Antibiotic use density and eradication rate according to seven geographic areas in Korea. There was no significant correlation between antibiotic use density and eradication rate by region
Figure 4
Figure 4
Yearly antibiotic use density and eradication rate from 2010 to 2015. There was no significant correlation between antibiotic use density and eradication rate over time

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References

    1. Graham DY, Dore MP. Helicobacter pylori therapy: a paradigm shift. Expert Rev Anti Infect Ther. 2016;14:577‐585. - PMC - PubMed
    1. Harb AH, Chalhoub JM. Abou Mrad R, Sharara AI. Systematic review and meta‐analysis: full‐ vs. half‐dose anti‐microbials in clarithromycin‐based regimens for Helicobacter pylori eradication. Aliment Pharmacol Ther. 2015;42:131‐141. - PubMed
    1. Hsu P‐I, Wu D‐C, Chen W‐C, et al. Randomized controlled trial comparing 7‐day triple, 10‐day sequential, and 7‐day concomitant therapies for Helicobacter pylori infection. Antimicrob Agents Chemother. 2014;58:5936‐5942. - PMC - PubMed
    1. Kim SG, Jung HK, Lee HL, et al. Guidelines for the diagnosis and treatment of Helicobacter pylori infection in Korea, 2013 revised edition. J Gastroenterol Hepatol. 2014;29:1371‐1386. - PubMed
    1. Fock KM, Talley N, Moayyedi P, et al. Asia‐Pacific consensus guidelines on gastric cancer prevention. J Gastroenterol Hepatol. 2008;23:351‐365. - PubMed

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