{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T23:09:53Z","timestamp":1789427393293,"version":"build-2803163510"},"reference-count":25,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2020,5,5]],"date-time":"2020-05-05T00:00:00Z","timestamp":1588636800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Helicobacter"],"published-print":{"date-parts":[[2020,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      <jats:italic>Helicobacter pylori<\/jats:italic>\n                      (Hp) infection increases the risk of gastric cancer. Therefore, eradication is a global goal, which requires continuous monitoring of therapeutic regimens and effectiveness. Clarithromycin resistance is an important contributor to eradication failure, and metronidazole is recommended as second\u2010line treatment in such cases. Here, we retrospectively evaluated the clarithromycin and metronidazole resistance rates and treatment effectiveness in patients with Hp using tailored therapies according to clarithromycin susceptibility testing.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Data on drug susceptibility were obtained for 5249 Japanese Hp patients between July 2005 and August 2018. Clarithromycin\/metronidazole resistance rates were analyzed according to year, gender, and age with Fisher's exact test. The relationship between clarithromycin resistance and Hp therapy outcomes was assessed for 1300 patients. Treatment regimens included a clarithromycin\u2010 or metronidazole\u2010containing 7\u2010day triple therapy with one of several proton pump inhibitors and vonoprazan.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Clarithromycin resistance increased annually and was higher in women and younger patients (&lt;30\u00a0years). Rates of metronidazole resistance were stable but decreased with age. Hp treatment regimens using PPIs had eradication rates of 88% and 45% among clarithromycin\u2010sensitive and clarithromycin\u2010resistant cases, respectively, while regimens including vonoprazan had eradication rates of around 90% regardless of clarithromycin susceptibility. In particular, triple therapy with vonoprazan, amoxicillin, and metronidazole achieved 98% eradication.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Clarithromycin\u2010containing triple therapy even using vonoprazan did not achieve satisfactory eradication rates even in the clarithromycin\u2010sensitive group. To avoid antibiotic misuse in population with low metronidazole resistance, 7\u2010day vonoprazan, amoxicillin, and metronidazole triple therapy might be a strong candidate as a first\u2010line eradication therapy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/hel.12698","type":"journal-article","created":{"date-parts":[[2020,5,5]],"date-time":"2020-05-05T07:49:32Z","timestamp":1588664972000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":30,"title":["<i>Helicobacter pylori<\/i>\n                    eradication therapy outcome according to clarithromycin susceptibility testing in Japan"],"prefix":"10.1111","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1959-899X","authenticated-orcid":false,"given":"Ryusuke","family":"Horie","sequence":"first","affiliation":[{"name":"Department of gastroenterology Japan Community Health care Organization Kyoto Kuramaguchi Medical Center Kyoto Japan"},{"name":"Department of Molecular Gastroenterology and Hepatology Graduate School of Medical Science Kyoto Prefectural University of Medicine Kyoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2228-0405","authenticated-orcid":false,"given":"Osamu","family":"Handa","sequence":"additional","affiliation":[{"name":"Department of Molecular Gastroenterology and Hepatology Graduate School of Medical Science Kyoto Prefectural University of Medicine Kyoto Japan"},{"name":"Division of Gastroenterology Department of Internal Medicine Kawasaki Medical School Okayama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takashi","family":"Ando","sequence":"additional","affiliation":[{"name":"Ando Clinic Kyoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8407-7221","authenticated-orcid":false,"given":"Takuya","family":"Ose","sequence":"additional","affiliation":[{"name":"Department of gastroenterology Japan Community Health care Organization Kyoto Kuramaguchi Medical Center Kyoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1398-3988","authenticated-orcid":false,"given":"Takaaki","family":"Murakami","sequence":"additional","affiliation":[{"name":"Department of gastroenterology Japan Community Health care Organization Kyoto Kuramaguchi Medical Center Kyoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5037-6861","authenticated-orcid":false,"given":"Norihisa","family":"Suzuki","sequence":"additional","affiliation":[{"name":"Department of gastroenterology Japan Community Health care Organization Kyoto Kuramaguchi Medical Center Kyoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rei","family":"Sendo","sequence":"additional","affiliation":[{"name":"Department of gastroenterology Japan Community Health care Organization Kyoto Kuramaguchi Medical Center Kyoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eiko","family":"Imamoto","sequence":"additional","affiliation":[{"name":"Department of gastroenterology Japan Community Health care Organization Kyoto Kuramaguchi Medical Center Kyoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9890-3635","authenticated-orcid":false,"given":"Yoshito","family":"Itoh","sequence":"additional","affiliation":[{"name":"Department of Molecular Gastroenterology and Hepatology Graduate School of Medical Science Kyoto Prefectural University of Medicine Kyoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,5,5]]},"reference":[{"key":"e_1_2_8_2_1","first-page":"1273","article-title":"Unidentified curved bacilli on gastric epithelium in active chronic gastritis","author":"Warren J","year":"1983","journal-title":"Lancet"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.5694\/j.1326-5377.1985.tb113443.x"},{"key":"e_1_2_8_4_1","first-page":"192","article-title":"Ingestion of Campylobacter pyloridis causes gastritis and raised fasting gastric pH","volume":"82","author":"Morris A","year":"1987","journal-title":"Am J Gastroenterol"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa001999"},{"key":"e_1_2_8_6_1","unstructured":"IARCHelicobacter pyloriWorking Group.Helicobacter pylorieradication as a strategy for preventing gastric cancer. International Agency for Research on Cancer (IARC Working Group Reports) No. 8 2014."},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1179\/174329211X12968219310756"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1053\/gast.2001.27999"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/dju116"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.g3174"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.3164\/jcbn.10-10"},{"key":"e_1_2_8_12_1","first-page":"386","article-title":"Primary and acquired Helicobacter pylori resistance to clarithromycin, metronidazole, and amoxicillin influence on treatment outcome","volume":"93","author":"Adamek RJ","year":"1998","journal-title":"Am J Gastroenterol"},{"key":"e_1_2_8_13_1","volume-title":"Performance standards for antimicrobial susceptibility testing; Twentieth informational supplement M100S20.2010: Suite","author":"Clinical and Laboratory Standards Institute","year":"2010"},{"key":"e_1_2_8_14_1","unstructured":"European Committee on Antimicrobial Susceptibility Testing.Breakpoint tables for interpretation of MICs and zone diameters. Version 4.0;2014."},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.15403\/jgld.2014.1121.253.7hp"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmi.2017.11.010"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10620-016-4091-8"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1080\/23744235.2017.1317359"},{"key":"e_1_2_8_19_1","doi-asserted-by":"crossref","first-page":"468","DOI":"10.1097\/MCG.0000000000000165","article-title":"Clarithromycin versus metronidazole as first\u2010line Helicobacter pylori eradication: a multicenter, prospective, randomized controlled study in Japan","volume":"49","author":"Nishizawa T","year":"2015","journal-title":"J Clin Gastroenterol"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1159\/000500819"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v20.i3.665"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1136\/gut.2009.192757"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2012-302084"},{"key":"e_1_2_8_24_1","first-page":"1","article-title":"Kusano Seven\u2010day vonoprazan and low\u2010dose amoxicillin dual therapy as first\u2010line Helicobacter pylori treatment: a multicentre randomised trial in Japan","author":"Suzuki S","year":"2019","journal-title":"Gut"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1159\/000502287"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1111\/hel.12310"}],"container-title":["Helicobacter"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fhel.12698","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/hel.12698","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/hel.12698","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/hel.12698","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,6]],"date-time":"2023-09-06T10:25:03Z","timestamp":1693995903000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/hel.12698"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,5,5]]},"references-count":25,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2020,8]]}},"alternative-id":["10.1111\/hel.12698"],"URL":"https:\/\/doi.org\/10.1111\/hel.12698","archive":["Portico"],"relation":{},"ISSN":["1083-4389","1523-5378"],"issn-type":[{"value":"1083-4389","type":"print"},{"value":"1523-5378","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,5,5]]},"assertion":[{"value":"2020-03-04","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-04-09","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-05-05","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e12698"}}