Current status of Helicobacter pylori eradication and risk factors for eradication failure

Table 1 Demographic and clinical characteristics of patients with Helicobacter pylori infection

Variable	Cases (n)	Percentage
Overall cases	2610
Gender
Male	1088	41.70%
Female	1522	58.30%
Age, range (yr)
< 30	582	22.30%
30-40	576	22.10%
40-50	478	18.30%
50-60	528	20.20%
> 60	446	17.10%
Chief complaint
Upper abdominal pain	406	15.60%
Abdominal distension	643	24.60%
Nausea	138	5.30%
Acid regurgitation or heartburn	250	9.60%
Bitter taste in mouth	157	6.00%
Belching	224	8.60%
Increased stool frequency	143	5.50%
Others	152	5.80%
No symptoms	1309	50.20%
Received gastroscopy	1390	53.30%
Endoscopic and pathological findings
Peptic ulcer	244	9.30%
Pre-neoplastic lesions	416	15.90%
MALT lymphoma or gastric cancer	17	0.70%
Eradication attempts
Primary	2237	85.70%
Rescue	373	14.30%

Table 2 Eradication rates of specific Helicobacter pylori regimens classified by proton pump inhibitor

PPI	Successful eradication (n)	Total (n)	Eradication rate (%)	95%CI (%)
Esomeprazole	566	698	81.1	78.2-84.0
Non-esomeprazole PPIs	1433	1912	74.9	73.0-76.8
Rabeprazole	657	836	78.6	75.8-81.4
Lansoprazole	43	55	78.2	67.3-89.1
Pantoprazole	449	607	74.0	70.5-77.5
Omeprazole	284	414	68.6	64.1-73.1

The following PPI dosages were prescribed: Esomeprazole, 20 mg bid; rabeprazole, 20 mg bid; omeprazole, 20 mg bid; lansoprazole, 30 mg bid; pantoprazole, 40 mg bid. PPI: Proton pump inhibitor.

Table 3 Subgroup comparison of eradication rates

	Antibiotic regimen	Successful eradication (n)	Total (n)	Eradication rate (%)	95%CI (%)
Primary	Total	1751	2237	78.3	76.6-80.0
	Amoxicillin plus clarithromycin	980	1166	84.0	81.9-86.1
	Amoxicillin plus levofloxacin	47	54	87.0	78.1-96.0
	Amoxicillin plus furazolidone	8	11	72.7	46.4-99.0
	Clarithromycin plus metronidazole	61	112	54.5	45.2-63.7
	Clarithromycin plus levofloxacin	647	871	74.3	71.4-77.2
	Clarithromycin plus furazolidone	7	20	35.0	14.1-55.9
	Levofloxacin plus furazolidone	1	3	33.3	0.0-86.7
Rescue	Total	248	373	66.5	61.7-71.3
	Amoxicillin plus clarithromycin	81	105	77.1	69.1-85.2
	Amoxicillin plus levofloxacin	13	22	59.1	38.5-79.6
	Amoxicillin plus furazolidone	42	52	80.8	70.1-91.5
	Clarithromycin plus metronidazole	20	36	55.6	39.3-71.8
	Clarithromycin plus levofloxacin	73	128	57.0	48.5-65.6
	Clarithromycin plus furazolidone	8	14	57.1	31.2-83.1
	Levofloxacin plus furazolidone	11	16	68.8	46.0-91.5

The following antibiotic dosages were prescribed: Amoxicillin, 1000 mg bid; clarithromycin, 500 mg bid; levoflaxacin, 500 mg qd or 200 mg bid; furazolidone, 100 mg bid; metronidazole, 200 mg bid, 400 mg bid, or 200 mg tid.

Table 4 Univariate and multivariate analyses of risk factors for eradication failure

Variable		Univariate analysis			Multivariate analysis
		OR	95%CI	P value	OR	95%CI	P value
Gender	Male	1 (Reference)
	Female	1.202	0.998-1.447	0.052
Age		1.018	1.011-1.024	< 0.001	1.014	1.008-1.021	< 0.001
Eradication attempts	Primary	1 (Reference)			1 (Reference)
	Rescue	1.816	1.432-2.302	< 0.001	1.538	1.179-2.007	0.002
Antibiotic regimens	Amoxicillin plus clarithromycin	1 (Reference)			1 (Reference)
	Amoxicillin plus levofloxacin	1.347	0.761-2.385	0.306	1.167	0.654-2.084	0.601
	Amoxicillin plus furazolidone	1.314	0.701-2.461	0.394	0.982	0.505-1.911	0.958
	Clarithromycin plus metronidazole	4.179	2.928-5.966	< 0.001	3.139	2.125-4.637	< 0.001
	Clarithromycin plus levofloxacin	1.958	1.599-2.397	< 0.001	1.863	1.517-2.287	< 0.001
	Clarithromycin plus furazolidone	6.4	3.200-12.797	< 0.001	5.748	2.834-11.655	< 0.001
	Levofloxacin plus furazolidone	2.947	1.147-7.574	0.025	2.115	0.798-5.605	0.132
PPIs	Esomeprazole	1 (Reference)			1 (Reference)
	Rabeprazole	1.168	0.909-1.502	0.225	1.138	0.879-1.473	0.327
	Lansoprazole	1.197	0.614-2.332	0.598	1.262	0.638-2.496	0.504
	Pantoprazole	1.509	1.161-1.961	0.002	1.398	1.067-1.831	0.015
	Omeprazole	1.963	1.482-2.600	< 0.001	1.513	1.113-2.056	0.008