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Helicobacter. 2019 Oct;24(5):e12646. doi: 10.1111/hel.12646. Epub 2019 Aug 1.

Online registry for nationwide database of Helicobacter pylori eradication in Korea: Correlation of antibiotic use density with eradication success.

Author information

1
Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Korea.
2
Department of Internal Medicine, Dongguk University College of Medicine Gyeongju Hospital, Gyeongju, Korea.
3
Department of Internal Medicine, Jeju National University School of Medicine, Jeju, Korea.
4
Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, Korea.
5
Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea.
6
Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea.
7
Department of Gastroenterology, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Bucheon, Korea.
8
Department of Internal Medicine, Ewha Womans University School of Medicine, Seoul, Korea.
9
Department of Internal Medicine, Cheonan Hospital, Soon Chun Hyang University College of Medicine, Cheonan, Korea.
10
Department of Internal Medicine, Kosin University Gospel Hospital, Kosin University College of Medicine, Busan, Korea.
11
Center for Gastric Cancer, National Cancer Center, Gyeonggi, Korea.
12
Department of Internal Medicine, Pusan Paik Hospital, Inje University College of Medicine, Busan, Korea.
13
Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Incheon, Korea.
14
Department of Internal Medicine, Hallym University College of Medicine, Seoul, Korea.
15
Department of Internal Medicine, Daegu Fatima Hospital, Daegu, Korea.
16
Department of Internal Medicine, Gyeongsang National University School of Medicine, Jinju, Korea.
17
Department of Internal Medicine, St. Paul's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
18
Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea.
19
Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
20
Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea.
21
Department of Biomedical Science, Seoul National University Graduate School, Seoul, Korea.
22
Cancer Research Institute, Seoul National University, Seoul, Korea.
23
Department of Prevention and Management, Inha University Hospital, School of Medicine, Inha University, Incheon, Korea.

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

PMID:
31368629
PMCID:
PMC6790945
DOI:
10.1111/hel.12646
[Indexed for MEDLINE]
Free PMC Article

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