Trends in the eradication rates of Helicobacterpylori infection for eleven years

AIM：To evaluate the trends in the eradication rate of Helicobacter pylori（H.pylori） over the past 11 years in a single center.METHODS：This retrospective study covered the period from January 2000 to December 2010.We evaluated 5746 patients diagnosed with gastric ulcers（GU）,duodenal ulcers（DU）,GU ＋ DU,or nonpeptic ulcers associated with an H.pylori infection.We treated them annually with the 2 wk standard first-line triple regimen,proton pump inhibitor（PPI） ＋ amoxicilin ＋ clarithromycin（PAC;PPI,clarithromycin 500 mg,and amoxicillin 1 g,all twice a day）.The follow-up test was performed at least 4 wk after the completion of the 2 wk standard H.pylori eradication using the PAC regimen.We also assessed the eradication rates of 1 wk second-line therapy with a quadruple standard regimen（PPI b.i.d.,tripotassium dicitrate bismuthate 300 mg q.i.d.,metronidazole 500 mg t.i.d.,and tetracycline 500 mg q.i.d.） after the failure of the first-line therapy.Statistical analysis was performed with 95%CI for the differences in the annual eradication rates.RESULTS：A total of 5746 patients [2333 males（58.8%）,1636 females（41.2%）;mean age of males vs females 51.31 ± 13.1 years vs 52.76 ± 13.6 years,P 〈 0.05,total mean age 51.9 ± 13.3 years（mean ± SD）] were investigated.Among these patients,1674 patients were excluded：35 patients refused treatment;18 patients ceased H.pylori eradication due to side effects;1211 patients had inappropriate indications for H.pylori eradication,having undergone stomach cancer operation or chemotherapy;and 410 patients did not undergo the follow-up.We also excluded 103 patients who wanted to stop eradication treatment after only 1 wk due to poor compliance or the side effects mentioned above.Finally,we evaluated the annual eradication success rates in a total of 3969 patients who received 2 wk first-line PAC therapy.The endoscopic and clinical findings in patients who received the 2 wk PAC were as follows：gastric ulcer in 855（21.5%）;duodenal ulcer in 878（22.1%）;gastric and duodenal ulcer in 124（3.1%）,erosive,atrophic gastritis and functional dyspepsia in 2055（51.8%）;and other findings（e.g.,MALToma,patients who wanted to receive the therapy even though they had no abnormal endoscopic finding） in 57（0.5%）.The overall eradication rate of the 2 wk standard firstline triple regimen was 86.5%.The annual eradication rates from 2000 to 2010 were 86.7%,85.4%,86.5%,83.3%,89.9%,90.5%,88.4%,84.5%,89.1%,85.8%,and 88.3%,sequentially（P = 0.06）.No definite evidence of