Susceptibility‐Guided Triple Therapy Achieves High Helicobacter pylori Eradication Regardless of Duration
- 1Department of Gastroenterology, Soonchunhyang University Seoul Hospital Soonchunhyang University College of Medicine Seoul South Korea
- 2Department of Gastroenterology, Asan Medical Center University of Ulsan College of Medicine Seoul South Korea
- 3Department of Microbiology Hanyang University College of Medicine Seoul South Korea
Abstract
Background and Aim: Although clarithromycin resistance is a major cause of empirical triple therapy failure for Helicobacter pylori eradication, the clinical relevance of amoxicillin susceptibility remains uncertain. We first compared eradication outcomes between empirical and susceptibility‐guided tailored triple therapy and then evaluated the influence of treatment duration and amoxicillin susceptibility among patients with clarithromycin‐susceptible strains receiving tailored triple therapy.
Methods: We retrospectively analyzed 807 patients receiving empirical or susceptibility‐guided tailored triple therapy in Korea from 2020 to 2024. Eradication outcomes were assessed in modified intention‐to‐treat (mITT) and per‐protocol (PP) populations by antibiotic susceptibility and treatment duration.
Results: Eradication rates were higher with tailored than empirical triple therapy (mITT: 92.9% vs. 69.3%, p < 0.001; PP: 93.7% vs. 69.7%, p < 0.001). Among patients with clarithromycin‐susceptible strains receiving tailored triple therapy, eradication rates were higher in amoxicillin‐susceptible than in amoxicillin‐resistant strains in the mITT analysis (94.0% vs. 86.8%, p = 0.034), whereas the difference was not statistically significant in the PP analysis (94.5% vs. 89.4%, p = 0.118). In the PP population, eradication rates did not differ significantly according to treatment duration in either amoxicillin‐susceptible (p = 0.073) or amoxicillin‐resistant strains (p = 0.884).
Conclusions: Among patients with clarithromycin‐susceptible strains receiving tailored triple therapy, eradication rates did not differ significantly according to treatment duration. However, these findings should be interpreted cautiously because the study may have been underpowered to detect modest but clinically meaningful differences. Amoxicillin susceptibility may be associated with eradication outcomes, although the statistical robustness of this association remains limited.
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BibTeX
@article{wang2026susceptibilityguided,
title = {{Susceptibility‐Guided Triple Therapy Achieves High Helicobacter pylori Eradication Regardless of Duration}},
author = {Hoyoung Wang and Ji Yong Ahn and Hee Kyong Na and Kee Wook Jung and Jeong Hoon Lee and Do Hoon Kim and Kee Don Choi and Ho June Song and Gin Hyug Lee and Hwoon‐Yong Jung and Jung Mogg Kim},
journal = {Journal of Gastroenterology and Hepatology},
year = {2026},
month = sep,
doi = {10.1111/jgh.70758},
url = {https://doi.org/10.1111/jgh.70758},
note = {CC BY-NC 4.0},
}
RIS
TY - JOUR
TI - Susceptibility‐Guided Triple Therapy Achieves High Helicobacter pylori Eradication Regardless of Duration
AU - Hoyoung Wang
AU - Ji Yong Ahn
AU - Hee Kyong Na
AU - Kee Wook Jung
AU - Jeong Hoon Lee
AU - Do Hoon Kim
AU - Kee Don Choi
AU - Ho June Song
AU - Gin Hyug Lee
AU - Hwoon‐Yong Jung
AU - Jung Mogg Kim
PY - 2026
DA - 2026/09/27
JO - Journal of Gastroenterology and Hepatology
DO - 10.1111/jgh.70758
UR - https://doi.org/10.1111/jgh.70758
AB - Background and Aim: Although clarithromycin resistance is a major cause of empirical triple therapy failure for Helicobacter pylori eradication, the clinical relevance of amoxicillin susceptibility remains uncertain. We first compared eradication outcomes between empirical and susceptibility‐guided tailored triple therapy and then evaluated the influence of treatment duration and amoxicillin susceptibility among patients with clarithromycin‐susceptible strains receiving tailored triple therapy. Methods: We retrospectively analyzed 807 patients receiving empirical or susceptibility‐guided tailored triple therapy in Korea from 2020 to 2024. Eradication outcomes were assessed in modified intention‐to‐treat (mITT) and per‐protocol (PP) populations by antibiotic susceptibility and treatment duration. Results: Eradication rates were higher with tailored than empirical triple therapy (mITT: 92.9% vs. 69.3%, p < 0.001; PP: 93.7% vs. 69.7%, p < 0.001). Among patients with clarithromycin‐susceptible strains receiving tailored triple therapy, eradication rates were higher in amoxicillin‐susceptible than in amoxicillin‐resistant strains in the mITT analysis (94.0% vs. 86.8%, p = 0.034), whereas the difference was not statistically significant in the PP analysis (94.5% vs. 89.4%, p = 0.118). In the PP population, eradication rates did not differ significantly according to treatment duration in either amoxicillin‐susceptible (p = 0.073) or amoxicillin‐resistant strains (p = 0.884). Conclusions: Among patients with clarithromycin‐susceptible strains receiving tailored triple therapy, eradication rates did not differ significantly according to treatment duration. However, these findings should be interpreted cautiously because the study may have been underpowered to detect modest but clinically meaningful differences. Amoxicillin susceptibility may be associated with eradication outcomes, although the statistical robustness of this association remains limited.
SN - 0815-9319
SN - 1440-1746
ER -