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Trends of Second‐Line Eradication Therapy for Helicobacter pylori in Japan: A Multicenter Study in the Tokyo Metropolitan Area
Author(s) -
Asaoka Daisuke,
Nagahara Akihito,
Matsuhisa Takeshi,
Takahashi Shinichi,
Tokunaga Kengo,
Kawai Takashi,
Kawakami Kohei,
Suzuki Hidekazu,
Suzuki Masayuki,
Nishizawa Toshihiro,
Kurihara Naoto,
Ito Masayoshi,
Sasaki Hitoshi,
Omata Fumio,
Mizuno Shigeaki,
Torii Akira,
Ohkusa Toshifumi,
Mine Tetsuya,
Sakaki Nobuhiro
Publication year - 2013
Publication title -
helicobacter
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.206
H-Index - 79
eISSN - 1523-5378
pISSN - 1083-4389
DOI - 10.1111/hel.12063
Subject(s) - helicobacter pylori , rabeprazole , lansoprazole , medicine , metronidazole , clarithromycin , omeprazole , amoxicillin , proton pump inhibitor , gastroenterology , first line , second line , antibiotics , microbiology and biotechnology , biology
Background In Japan, the eradication rate of first‐line therapy for Helicobacter pylori ( H. pylori ) with a proton pump inhibitor ( PPI ), amoxicillin ( AMPC ) and clarithromycin ( CAM ) has been decreasing because of a high prevalence of CAM resistance. A possible decrease of the eradication rate for second‐line therapy with a PPI , AMPC and metronidazole ( MNZ ) is of concern. The aim of this study is to assess the trends in second‐line eradication therapy for H. pylori in Japan. Materials and Methods We accumulated data retrospectively on patients administered second‐line eradication therapy for Helicobacter pylori with a PPI, AMPC, and MNZ for 1 week after failure of first‐line eradication therapy with a PPI, AMPC and CAM at 15 facilities in the Tokyo metropolitan area in Japan from 2007 to 2011. Trends for second‐line eradication rates in modified intention‐to‐treat ( ITT ) analyses were investigated. Second‐line eradication rates were categorized by three PPI s (rabeprazole ( RPZ ), lansoprazole ( LPZ ) or omeprazole ( OMZ )) and evaluated. Results We accumulated data on 1373 patients. The overall second‐line eradication rate was 92.4%. Second‐line eradication rates in 2007, 2008, 2009, 2010 and 2011 were 97.7, 90.6, 94.5, 91.8 and 91.8%, respectively, with no significant trends revealed. Second‐line eradication rates categorized by three PPI s for the entire 5‐year period were 91.6, 93.4 and 92.4% ( RPZ , LPZ and OPZ , respectively) with no significant differences among the three PPI s. Conclusions From 2007 to 2011, there were no significant trends in the second‐line eradication rates and the rates remained consistently high. From the viewpoint of high prevalence of CAM resistance in Japan, triple therapy with PPI , AMPC and MNZ may be a better strategy for first‐line therapy compared to triple therapy with PPI , AMPC and CAM .