Recurrence of Helicobacter pylori following successful eradication and clinical outcomes in Korean patients

Background/Aims Helicobacter pylori (H. pylori) infections can recur as either recrudescence or reinfection. At a time when the decline in the eradication rate is becoming evident, increases in the rate of recurrence are concerning. In addition, there are no guidelines for selecting an eradication regimen for H. pylori recurrence. Materials and Methods A total of 996 H. pylori‐infected patients treated with proton‐pump inhibitor‐based triple eradication therapy between 2017 and 2022 were enrolled in the study, and successful eradication therapies were confirmed by the 13C‐urea breath test. When retested within 1 year after successful eradication, analysis related to recrudescence was performed, and when retested after 1 year, analysis related to reinfection was performed. We reviewed the medical records and treatment outcomes of patients with H. pylori reinfection after successful eradication. Results The recrudescence rate was 3.9% (9/228), and the reinfection rate was 3.7% (36/970 person‐year). The frequency of reinfection reached 5.9% per person‐year within the first 24 months and 2.0%–2.4% per person‐year thereafter. In multivariate factor analysis, reinfection was significantly higher in patients with non‐ulcer dyspepsia (p