Delay of second-line eradication therapy for Helicobacter pylori can increase eradication failure

Authors

  • Toshihiro Nishizawa,

    1. Division of Gastroenterology, National Hospital Organization Tokyo Medical Center, Tokyo, Japan
    2. Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan
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  • Hidekazu Suzuki,

    Corresponding author
    1. Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan
    • Division of Gastroenterology, National Hospital Organization Tokyo Medical Center, Tokyo, Japan
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  • Masahiko Takahashi,

    1. Division of Gastroenterology, National Hospital Organization Tokyo Medical Center, Tokyo, Japan
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  • Masayuki Suzuki,

    1. Division of Gastroenterology, National Hospital Organization Tokyo Medical Center, Tokyo, Japan
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  • Toshifumi Hibi

    1. Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan
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Correspondence

Dr Hidekazu Suzuki, Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan. Email: hsuzuki@a6.keio.jp

Abstract

Background and Aim

The interval between first-line Helicobacter pylori eradication treatment and second-line treatment may be critical to the second-line therapeutic effect. We attempted to assess the association between the second-line eradication rates and the treatment interval.

Methods

Data of patients, who were administered the second-line H. pylori eradication regimen at Tokyo Medical Center between 2008 and 2012, were reviewed.

Results

Of the 148 patients enrolled, one patient dropped out. The eradication rates were 88.6% (intention-to-treat [ITT]) and 89.3% (per-protocol [PP]) for early eradication group (eradication interval < 180 days, patients number 132) and 68.8% (ITT and PP) for delayed eradication group (eradication interval ≥ 180 days, patients number 16). The eradication rate in the delayed eradication group was significantly lower than in the early eradication group (P = 0.027 [ITT] and 0.021 [PP]). The eradication interval in the subjects showing eradication failure (124.0 ± 96.8 days, patients number 19) was significantly longer than those showing successful eradication (85.8 ± 56.9 days, patients number 128, P = 0.008).

Conclusion

Our results suggest that the delay of second-line treatment should be avoided.

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