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Proton pump inhibitor (PPI)-based triple therapy consisting of PPI, amoxicillin, andclarithromycin, is the recommended first-line treatment for Helicobacter pylori infection. However, the eradication rate of triple therapy has declined over the past few decades. Weanalyzed the eradication rate and adverse events of triple therapy to evaluate currentpractices in Korea. A comprehensive literature search was performed up to August 2013 of104 relevant studies comprising 42,124 patients. The overall eradication rate was 74.6%(95% confidence interval [CI], 72.1%-77.2%) by intention-to-treat analysis and 82.0%(95% CI, 80.8%-83.2%) by per-protocol analysis. The eradication rate decreasedsignificantly from 1998 to 2013 (P < 0.001 for both intention-to-treat and per-protocolanalyses). Adverse events were reported in 41 studies with 8,018 subjects with an overallincidence rate of 20.4% (95% CI, 19.6%-21.3%). The available data suggest that theeffectiveness of standard triple therapy for H. pylori eradication has decreased to anunacceptable level. A novel therapeutic strategy is warranted to improve the effectivenessof first-line treatment for H. pylori infection in Korea.

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