IDDF2021-ABS-0037 Prospective evaluation of amoxicillin-clarithromycin triple therapy in private clinical practice in Hong Kong from 2008 to 2020

Abstract

<h3>Background</h3> There is a scarcity of local data regarding the current effectiveness of standard triple therapy in the treatment of Heliobacter pylori infection. To address the rising trend of bacterial resistance to antibiotics, we aim to monitor the efficacy of clarithromycin-containing triple therapy as a first-line treatment in Hong Kong and to assess the need for a longer treatment duration. <h3>Methods</h3> 440 patients with a positive rapid urease test in oesophago-gastro-duodenoscopy (OGD) received clarithromycin-based triple therapy for a period of 7, 10 or 14 days according to treatment guidelines in the corresponding period of time. Patient demographics, indications for endoscopy and endoscopic diagnoses are detailed in Table 1 (IDDF2021-ABS-0037 Table 1). Either a 7-day or 10-day treatment course was given between the period of 2008-2013, while a 10-day course was given from 2014-2015 and a 14-day course was given from 2016 onwards. Data analysis was carried out with chi-squared tests. Data presented as n (%). Both diagnoses were counted for those with two diagnosis, thus percentage total may exceed 100%. Other indications for endoscopy included anorexia, epigastric discomfort, globus in throat, odynophagia, weight loss, dysphagia, hiccup, raised CA72.4, raised CEA, tarry stool, and those who were asymptomatic. Other endoscopic diagnoses included oesophageal ulcer, oesophagitis, gastric polyp, duodenitis, and oesophageal squamous dysplasia. <h3>Results</h3> 282 patients (165 female, 117 male; mean age ± standard deviation, 47.5± 12.1 years; range, 19-78 years old) with follow-up data were included in the study. A trend of decreasing eradication rates was observed from 2008 to 2015 (p=0.026). These results are demonstrated in Table 2 (IDDF2021-ABS-0037 Table 2). Increasing the duration of treatment from 10 days to 14 days was found to achieve a significantly higher H. pylori eradication rate between 2016 to 2020. (p=0.032). This is reflected in the findings in Table 3 (IDDF2021-ABS-0037 Table 3). <h3>Conclusions</h3> Clarithromycin-based triple therapy remains an effective first-line therapy for H. pylori eradication in Hong Kong, but a treatment duration of 14 days should be given instead of 7 or 10 days.