{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T05:07:45Z","timestamp":1775797665102,"version":"3.50.1"},"reference-count":33,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T00:00:00Z","timestamp":1775779200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>\n                      While vonoprazan-amoxicillin dual therapy has achieved &amp;gt; 90% eradication rates for\n                      <jats:italic>Helicobacter pylori (H. pylori)<\/jats:italic>\n                      in clinical trials, its effectiveness in \u201creal-world\u201d regions with high primary antibiotic resistance and ethnic diversity remains under-verified. This multicenter study evaluated whether simplified vonoprazan-based regimens can overcome these regional barriers compared to standard rabeprazole-based dual therapy.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This retrospective analysis (April 2022\u2013November 2023) included 598\n                      <jats:italic>H. pylori<\/jats:italic>\n                      -positive outpatients from 10 centers across 8 prefectures of Guizhou. Patients received one of four 14-day therapies: Group A (vonoprazan 20\u202fmg b.i.d. + amoxicillin 1\u202fg t.i.d.), Group B (vonoprazan 20\u202fmg q.d. + amoxicillin 1\u202fg t.i.d.), Group C (vonoprazan 20\u202fmg q.d. + amoxicillin 1\u202fg b.i.d. + furazolidone 100\u202fmg b.i.d. + colloidal bismuth pectin 100\u202fmg t.i.d.), Group D (rabeprazole 20\u202fmg b.i.d. + amoxicillin 1\u202fg t.i.d.). The primary endpoint was the eradication rate, confirmed by 13C\/14C urea breath tests at least 4 weeks post-treatment.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      After excluding patients lost to follow-up and those with poor compliance, the eradication rates were 87.2% (Group A), 81.4% (Group B), 82.1% (Group C), and 71.5% (Group D). Group A achieved a significantly higher eradication rate than Group D (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001), while no other significant between-group differences were observed. However, none of the regimens reached the 90% \u201coptimal\u201d threshold. Notably, the once-daily (q.d.) vonoprazan regimens (Groups B and C) failed to reach the 85% clinical acceptability threshold in this specific geographic cohort. No significant association was observed between treatment success and age, sex, or ethnicity.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In the high-resistance environment of Guizhou, vonoprazan-based regimens are significantly more effective than traditional rabeprazole-based dual therapy, yet they face unique regional challenges. The failure of q.d. vonoprazan dosing and the sub-90% success rate of b.i.d. dosing suggest that in regions with extreme resistance and high ethnic diversity, standard global protocols may require further optimization.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1801129","type":"journal-article","created":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T04:26:22Z","timestamp":1775795182000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Real-world effectiveness of vonoprazan-based regimen versus rabeprazole-based dual therapy for Helicobacter pylori eradication in a high-resistance, multi-ethnic region: a multicenter study in Guizhou, China"],"prefix":"10.3389","volume":"13","author":[{"given":"Yurong","family":"Huang","sequence":"first","affiliation":[{"name":"Department of Gastroenterology, The Affiliated Hospital of Guizhou Medical University","place":["Guiyang, Guizhou, China"]},{"name":"Department of Gastroenterology, Liupanshui People's Hospital","place":["Liupanshui, Guizhou, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juan","family":"Zheng","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, The Affiliated Hospital of Guizhou Medical University","place":["Guiyang, Guizhou, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhengyi","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, The Affiliated Hospital of Guizhou Medical University","place":["Guiyang, Guizhou, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daili","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, The Affiliated Hospital of Guizhou Medical University","place":["Guiyang, Guizhou, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hua","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, The Affiliated Hospital of Guizhou Medical University","place":["Guiyang, Guizhou, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wenzhong","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Tongren People\u2019s Hospital","place":["Tongren, Guizhou, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wenjuan","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Xingyi People\u2019s Hospital","place":["Xingyi, Guizhou, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Min","family":"Gan","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Anshun People\u2019s Hospital","place":["Anshun, Guizhou, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Changmei","family":"Shi","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, The Affiliated Hospital of Guizhou Medical University","place":["Guiyang, Guizhou, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dongmei","family":"Xie","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, The Affiliated Hospital of Guizhou Medical University","place":["Guiyang, Guizhou, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Canyu","family":"Zhan","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Xingyi People\u2019s Hospital","place":["Xingyi, Guizhou, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gengqing","family":"Song","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, MetroHealth Medical Center, Case Western Reserve University","place":["Cleveland, OH, United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jie","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, The Affiliated Hospital of Guizhou Medical University","place":["Guiyang, Guizhou, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,4,10]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"191","DOI":"10.3390\/antibiotics12020191","article-title":"Helicobacter pylori infection: current status and future prospects on diagnostic, therapeutic, and control challenges","volume":"12","author":"Elbehiry","year":"2023","journal-title":"Antibiotics"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"553","DOI":"10.1016\/S2468-1253(23)00070-5","article-title":"Global prevalence of Helicobacter pylori infection between 1980 and 2022: a systematic review and 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