Iatrogenic factors of Helicobacter pylori eradication failure: lessons from the frontline

ABSTRACT

Background

Iatrogenic factors play an important role in H. pylori eradication failure, whereas it can be easily missed. Therefore, we aimed to investigate and analyze these related iatrogenic factors of H. pylori eradication failure.

Methods

A total of 508 patients who experienced H. pylori eradication failure were included in this study conducted from December 2019 to February 2022. All the patients filled out a questionnaire including demographic characteristics, duration of treatment, regimens, dosage, and time intervals in rescue treatment.

Results

In the first-line treatment, 89 patients (17.5%, 89/508) used at least one antibiotic with high resistance rate in triple therapy and 57 patients (11.2%, 57/508) used two antibiotics with high resistance rates or other not recommended antibiotics in quadruple therapy. In the rescue therapy, 85 regimens were repeatedly used as salvage regimens in 58 patients (22.6%, 58/257) and 178 regimens containing antibiotics with high resistance rates were repeatedly used in 85 patients (33.1%, 85/257).

Conclusion

To decrease the risk of H. pylori eradication failure, iatrogenic factors need to gain more attention. Clinicians should enhance their education and training to standardize the treatment regimens, better manage the H. pylori infection, and improve the eradication rate eventually.

KEYWORDS:

• Iatrogenic factors
• H. pylori
• eradication failure
• First-line treatment
• rescue therapy
• treatment regimens

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Ethical approval

This study protocol was approved by The Ethics Committee of The First Affiliated Hospital of Nanchang University (NO: 2020-013).

Supplementary material

Supplemental data for this article can be accessed online at https://doi.org/10.1080/14787210.2023.2181788

Additional information

Funding

This work was supported by grants from the National Natural Science Foundation of China (No. 81970502, No. 82270593, No. 82060109) and the Science and Technology Projects of Jiangxi Province (20203BBG73051)