Delay of second-line eradication therapy for Helicobacter pylori can increase eradication failure

The interval between first-line Helicobacter pylori eradication treatment and second-line treatment may be critical to the second-line therapeutic effect. We attempted to assess the association between the second-line eradication rates and the treatment interval.

Data of patients, who were administered the second-line H. pylori eradication regimen at Tokyo Medical Center between 2008 and 2012, were reviewed.

Of the 148 patients enrolled, one patient dropped out. The eradication rates were 88.6% (intention-to-treat [ITT]) and 89.3% (per-protocol [PP]) for early eradication group (eradication interval < 180 days, patients number 132) and 68.8% (ITT and PP) for delayed eradication group (eradication interval ≥ 180 days, patients number 16). The eradication rate in the delayed eradication group was significantly lower than in the early eradication group (P = 0.027 [ITT] and 0.021 [PP]). The eradication interval in the subjects showing eradication failure (124.0 ± 96.8 days, patients number 19) was significantly longer than those showing successful eradication (85.8 ± 56.9 days, patients number 128, P = 0.008).

Our results suggest that the delay of second-line treatment should be avoided.