Research Article: Evaluation of eradication efficacy and optimization strategies for Helicobacter pylori infection based on real-world data: a multivariable retrospective study
Abstract:
Based on real-world clinical data, this study aims to evaluate the differences in eradication efficacy among various H. pylori treatment regimens and the impact of prescription appropriateness on treatment outcomes.
This single-center retrospective study included 897 patients with confirmed H. pylori infection (September 2022–September 2025). Eradication rates were compared among dual, triple, and bismuth-containing quadruple therapies, stratified by prescription appropriateness per 2022 Chinese guidelines. Multivariable logistic regression and stratified analyses were performed to assess factors associated with eradication success and follow-up adherence.
Overall ITT and PP eradication rates were 79.04 and 90.23%, respectively. Quadruple therapy achieved the highest rates (ITT: 81.42%; PP: 93.76%), outperforming dual and triple therapies. Prescription appropriateness significantly affected eradication in the quadruple therapy group ( p <?0.01). In quadruple therapy, female was associated with higher eradication success (OR?=?2.53, 95% CI: 1.15–5.73). In the inappropriate dual therapy subgroup, amoxicillin dose (<2.0?g vs. ?2.0?g/day) did not significantly alter eradication rates. Older patients and those using TCM demonstrated better follow-up compliance.
Clinical practice should prioritize guideline-recommended regimens and standards; however, actual eradication effectiveness may vary depending on the regimen selected. Among these, bismuth-containing quadruple therapy should be the first-line treatment of choice and should be used in strict accordance with guideline standards.
Introduction:
Helicobacter pylori (H. pylori) infection is highly prevalent worldwide, affecting approximately 48.9% of the global population ( 1 ). As a significant risk factor for various digestive system diseases, H. pylori has been classified as a Group I carcinogen by the World Health Organization ( 2 ). Eradicating H. pylori not only alleviates gastrointestinal symptoms but also reduces the risk of gastric cancer ( 3 ). H. pylori eradication therapy is currently recommended by clinical guidelines worldwide. Commonly used…
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