Current status of eradication therapy and antimicrobial susceptibility testing for Helicobacter pylori in Japan: A nationwide questionnaire survey

INTRODUCTION: To improve the eradication success rate of Helicobacter pylori, treatment combined with antimicrobial susceptibility testing (AST) is recommended. However, AST procedures are not yet standardized in Japan. Understanding the implementation status of AST at individual facilities, identifying the associated issues, and addressing the challenges to standardization are crucial. METHODS: A questionnaire-based survey was used in this study to investigate the current status of eradication therapy and AST among physicians certified in H. pylori infection from the Japanese Society for Helicobacter Research and members of the Japanese Society for Clinical Microbiology. RESULTS: The vonoprazan/amoxicillin/clarithromycin regimen was selected as first-line therapy in 94% of the facilities. Approximately 24% of facilities reported a first-line eradication success rate of below 80%. Regarding AST, 18% of physicians certified in H. pylori infection from the Japanese Society for Helicobacter Research reported performing the test, compared to 70% of members from the Japanese Society for Clinical Microbiology. The most commonly used methods differed between the two groups: the agar dilution method was predominant in the former, whereas disk diffusion methods, including the E-test, and microdilution method were common in the latter. CONCLUSION: The status of AST for H. pylori varies widely across Japan. To achieve nationwide standardization, it is essential to establish robust quality control measures and promote the use of standardized reference panel strains for AST.