Eradication Rates of Helicobacter pylori in Korea Over the Past 10 years and Correlation of the Amount of Antibiotics Use: Nationwide Survey

• Published in: Helicobacter (Cambridge, Mass.) Mass.), 2016-08, Vol.21 (4), p.266-278
• Main Authors: Shin, Woon Geon, Lee, Sang Woo, Baik, Gwang Ho, Huh, Kyu Chan, Lee, Sang In, Chung, Jun-Won, Jung, Woon Tae, Park, Moo In, Jung, Hye-kyung, Kim, Heung Up, Kim, Jeong Hwan, Seol, Sang Young, Yoon, Soon Man, Jeon, Seong Woo, Hong, Su Jin, Kim, Gwang Ha, Lee, Dong Ho, Kim, Hyun Soo, Choi, Suck Chei, Kang, Hee Mo, Lee, Joongyub, Kim, Jae Gyu, Kim, Jae J.
• Format: Article
• Language: English
• Subjects: Adult; Aged; Amoxicillin - therapeutic use; Anti-Bacterial Agents - therapeutic use; Antibiotics; Clarithromycin - therapeutic use; Drug Utilization; Helicobacter Infections - drug therapy; Helicobacter pylori; Humans; Korea; Male; Middle Aged; Proton Pump Inhibitors - therapeutic use; Spatio-Temporal Analysis; Surveys and Questionnaires; Treatment Failure; trends; Ulcers; Young Adult
• ISSN: 1083-4389; 1523-5378
• DOI: 10.1111/hel.12279

Background The efficacy of proton‐pump inhibitor–amoxicillin–clarithromycin therapy for H. pylori eradication has decreased over time. Objective We assessed the trend of H. pylori eradication rates over the last 10 years and the relationship between the eradication rates and the amount of macrolide antibiotic use in a country with a high prevalence of H. pylori infection. Methods This vast nationwide multicenter study was conducted with 34,139 adults treated for H. pylori infection from January 2001 to December 2010. The defined daily dose per km2 (DSD) of macrolide antibiotics was calculated (n = 141,019) using the Health Insurance Review & Assessment data base from 2008 to 2010 in the two cities which had the lowest (Jeju city) or highest (Chuncheon city) eradication rate. Results The eradication rates of proton‐pump inhibitor–amoxicillin–clarithromycin therapy ranged 84.9–87.5% from 2001 to 2007, and those of 2008 to 2010 ranged 80.0–81.4% with a decreasing trend (p < 0.0001). The decreasing trend of eradication rates for the overall first‐line therapy was observed only in three of the seven geographic areas in Korea (p < 0.0001). The DSD of macrolide antibiotics was significantly higher in Jeju than Cheunchon city (0.85 vs 0.52, p < 0.0001). Conclusions H. pylori eradication rates with clarithromycin‐containing triple therapy in Korea showed a decreasing trend over the past 10 years, although the trend varied among geographic areas. This difference may be associated with the amount of macrolide antibiotic use.