Jianping Cheng,1 Chanjuan Fan,1 Zhen Li,1 Zhaojing Dong,2 Xiaolin Zhao,1 Yong Cai,1 Haiou Ding,3 Yan Dou,4 Xiaomei Zhang4 

1Department of Gastroenterology and Oncology, Civil Aviation General Hospital, Beijing, People’s Republic of China; 2Department of Medical Record, Civil Aviation General Hospital, Beijing, People’s Republic of China; 3Department of Pharmacy, Civil Aviation General Hospital, Beijing, People’s Republic of China; 4Department of Gastroenterology and Hepatology, The First Medical Center, Chinese PLA General Hospital, Beijing, People’s Republic of China

Correspondence: Jianping Cheng, Department of Gastroenterology and Oncology, Civil Aviation General Hospital, Beijing, 100123, People’s Republic of China, Tel +86 10 85762244, Email cjpczy2004@163.com Xiaomei Zhang, Department of Gastroenterology and Hepatology, The First Medical Center, Chinese PLA General Hospital, Beijing, 100112, People’s Republic of China, Email zhangxiaomeinew@163.com

Background and Objectives: The success rate of Helicobacter pylori (H. pylori) eradication in China is declining. The aim of this study was to evaluate eradication outcomes in clinical practice and identifies factors contributing to treatment failure.
Methods: A retrospective review was conducted on patients treated for H. pylori infection with 14-day bismuth-containing quadruple therapy at a Beijing medical center from January 2020 to December 2023. We analyzed demographic and clinical data, eradication rates across regimens, and performed multivariate analysis to pinpoint predictors of failure.
Results: Out of 3340 participants, 2273 (68.1%) achieved eradication. Amoxicillin-based combinations (69.2%) outperformed other antibiotic regimens (58.9%, p < 0.001), with amoxicillin plus doxycycline reaching a 71.4% success rate. Esomeprazole-based regimens were more effective (73.6%) than other PPI regimens (65.2%, p = 0.001), notably, a rabeprazole, amoxicillin, doxycycline, and bismuth combination had an 80.0% success rate. Age, gender, and smoking and drinking were significant eradication failure predictors.
Conclusion: In real-world settings, 14-day amoxicillin and esomeprazole-based quadruple regimens have been demonstrated to be more effective than other regimens. Age, gender, and lifestyle habits are identified as independent risk factors for eradication failure.
Registration: This study was registered in the Chinese Clinical Trial Registry on 08/01/2024 (clinical trial registration number: ChiCTR2400079647).

Keywords: Helicobacter pylori, quadruple therapy, antibiotics, proton pump inhibitor, retrospective study