Antibiotic treatment for Helicobacter pylori: Is the end coming?

Table 1 Decline in rates of Helicobacter pylori eradication following first-line standard triple therapy

Country	Ref.	Publication	Treatment duration	Patients	Therapy regimen	Eradication rate (ITT)	Eradication rate (PP)
South Korea	Na et al[177]	2007	7 d	3267	Standard PPI	NA	84.3%
					Cla 500 mg bid
					Amo 1 g bid
	Chung et al[178]	2012	10 d	80	Lan 30 mg bid	58.7%	67.6%
					Cla 500 mg bid
					Amo 1 g bid
Japan	Asaka et al[179]	2001	7 d	96	Lan 30 mg bid	NA	90.7%
					Cla 200 mg bid
					Amo 750 mg bid
	Fujioka et al[180]	2012	7 d	3162	Rab 10 mg bid	80.7%	NA
					Amo 750 mg bid
					Cla 200 mg bid
	Nishizawa et al[27]	2012	7 d	55	Lan 30 mg bid	74.5%	80.4%
					Cla 400 mg bid
					Amo 750 mg bid
	Nishida et al[181]	2014	7 d	134/134	Eso 20 mg bid	69.4%/73.9%	76.9%/79.8%
					Cla 400 mg bid
					Amo 750 mg bid
					Lan 30 mg bid
					Cla 400 mg bid
					Amo 750 mg bid
Taiwan	Sheu et al[182]	2000	7 d or 2 wk	286	Ome 20 mg bid	NA	87.8%
					Amo 1 g bid
					Cla or Met bid
	Chen et al[117]	2014	7 d	73	Rab 20 mg bid	57.5%	61.8%
					Cla 500 mg bid
					Amo 1 g bid
Turkey	Ozçay et al[183]	2004	4 wk: PPI 2 wk:Cla, Amo	102	Ome or Lan	NA	75.7%
					Cla 7.5 mg/kg bid
					Amo 20 mg/kg bid
	Kutluk et al[184]	2014	10 d	74	Lan 1 mg/kg per day	52.7%	55.7%
					Cla 20 mg/kg per day
					Amo 50 mg/kg per day
Italy	Catalano et al[185]	1999	10 d	84	Ome 20 mg bid	NA	94.0%
					Cla 500 mg bid
					Amo 1 g bid
	Paoluzi et al[186]	2010	7 d	90	Eso 20 mg bid	66.0%	75.0%
					Cla 500 mg bid
					Amo 1 g bid
Latin America	Greenberg et al[106]	2011	14 d	488	Lan 30 mg bid	82.2%	87.1%
					Cla 500 mg bid
					Amo 1 g bid

ITT: Intention to treat; PP: Per protocol; PPI: Proton pump inhibitor; NA: Not available; Cla: Clarithromycin; Amo: Amoxicillin; Lan: Lansoprazole; Rab: Rabeprazole; Eso: Esomeprazole; Ome: Omeprazole; Met: Metronidazole.

Table 2 Helicobacter pylori eradication rates following first-line sequential therapy

Country	Ref.	Publication	Treatment duration	Patients	Therapy regimen	Eradication rate (ITT)	Eradication rate (PP)
South Korea	Lee et al[92]	2014	10 d	111	1st 5 d: Eso + Amo	72.1%	78.4%
					2nd 5 d: Eso + Cla + Met
	Lee et al[91]	2015	10 d	100	1st 5 d: Rab + Amo	79.0%	84.9%
					2nd 5 d: Rab + Cla + Met
China	Zhou et al[93]	2014	10 d	140	1st 5 d: Eso + Amo	72.1%	76.5%
					2nd 5 d: Eso + Cla + Tin
Qatar	Ben Chaabane et al[94]	2015	14 d	106	1st 7 d: Rab + Amo	66.0%	76.0%
					2nd 7 d: Rab + Cla + Met
Italy	Pontone et al[187]	2010	10 d	84	1st 5 d: Lan + Amo	83.3%	90.9%
					2nd 5 d: Lan + Cla + Met
Spain	Molina-Infante et al[114]	2010	10 d	115	1st 5 d: Ome + Amo	76.5%	80.8%
					2nd 5 d: Ome + Cla + Met

ITT: Intention to treat; PP: Per protocol; Lan: Lansoprazole; Amo: Amoxicillin; Cla: Clarithromycin; Met: Metronidazole; Ome: Omeprazole; Eso: Esomeprazole; Tin: Tinidazole; Rab: Rabeprazole.

Table 3 Helicobacter pylori eradication rates following first-line concomitant therapy

Country	Ref.	Publication	Treatment duration	Patients	Therapy regimen	Eradication rate (ITT)	Eradication rate (PP)
South Korea	Lim et al[104]	2013	14 d	78	Rab 20 mg bid	80.8%	81.3%
					Amo 1 g bid
					Cla 500 mg bid
					Met 500 mg bid
	Lee et al[100]	2015	7 d	170	Rab 20 mg bid	79.4%	94.4%
					Amo 1 g bid
					Cla 500 mg bid
					Met 500 mg tid
Thailand	Kongchayanun et al[188]	2012	5 d/10 d	55/55	Rab 20 mg bid	89.1%/96.4%	NA
					Amo 1 g bid
					Met 400 mg tid
					Cla 1 g qd
Singapore	Ang et al[102]	2015	10 d	153	PPI standard does	81.7%	95.4%
					Amo 1 g bid
					Cla 500 mg bid
					Met 400 mg bid
Spain	Molina-Infante et al[97]	2012	10 d	209	PPI standard does	87.0%	89.0%
					Amo 1 g bid
					Cla 500 mg bid
					Met 500 mg bid
	McNicholl et al[103]	2014	10 d	168	Ome 20 mg bid	87.0%	91.0%
					Amo 1 g bid
					Cla 500 mg bid
					Met 500 mg bid
Latin America	Greenberg et al[106]	2011	5 d	489	Lan 30 mg bid	73.6%	NA
					Amo 1 g bid
					Cla 500 mg bid
					Met 500 mg bid

ITT: Intention to treat; PP: Per protocol; NA: Not available; Lan: Lansoprazole; Amo: Amoxicillin; Cla: Clarithromycin; Met: Metronidazole; PPI: Proton pump inhibitor; Rab: Rabeprazole; Ome: Omeprazole.

Table 4 Helicobacter pylori eradication rates following first-line levofloxacin-containing therapy

Country	Ref.	Publication	Treatment duration	Patients	Therapy regimen	Eradication rate (ITT)	Eradication rate (PP)
South Korea	Choi et al[189]	2011	7 d	98	Ome 20 mg bid	65.3%	73.6%
					Lev 200 mg bid
					Amo 1 g bid
China	Liao et al[122]	2013	14 d	81	Lan 30 mg bid	82.7%	85.9%
					Lev 500 mg qd
					Amo 1 g bid
Taiwan	Liou et al[190]	2010	7 d	217	Lan 30 mg bid	74.2%	80.1%
					Lev 750 mg qd
					Amo 1 g bid
	Chen et al[117]	2014	7 d	73	Rab 20 mg bid	78.1%	80.9%
					Lev 500 mg bid
					Amo 1 g bid
Spain	Molina-Infante et al[114]	2010	10 d	115	Ome 20 mg bid	80.8%	82.6%
					Lev 500 mg bid
					Amo 1 g bid

ITT: Intention to treat; PP: Per protocol; Lan: Lansoprazole; Lev: Levofloxacin; Amo: Amoxicillin; Rab: Rabeprazole; Eso: Esomeprazole; Cla: Clarithromycin; Ome: Omeparzole.