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KMID : 0359020090380010014
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Korean Journal of Gastrointestinal Endoscopy
2009 Volume.38 No. 1 p.14 ~ p.19
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Recent Trends in the Eradication Rates of Second-Line Quadruple Therapy for Helicobacter Pylori and the Clinical Factors that Potentially Affect the Treatment Outcome
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Jo Eun-Ju
Lee Dong-Ho
Chun Jae-Young
Choi Jong-Kyung
Hwang Sung-Wook
Lee Sang-Hyub
Park Young-Soo
Hwang Jin-Hyeok
Kim Jin-Wook
Jeong Sook-Hyang
Kim Na-Young
Jung Hyun-Chae
Song In-Sung
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Abstract
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Background/Aims: The present study aimed to evaluate the efficacy of second-line quadruple therapy for treating patients with Helicobacter Pylori, and these patients were treated at our hospitals for September, 2003 through April, 2008 in
Seongnam, Korea.
Methods: One hundred and thirty-three patients who failed to respond to the initial PPI-based triple therapy received quadruple therapy, whcih consisted of PPI, bismuth, tetracycline and metronidazole. The patients were divided into two groups. One group was treated for 7 days and the other group was treated for 14 days. Four to six weeks after completing the schedule, a 13C-urea breath test was performed to detect the presence of H. pylori.
Results: The overall intention-to-treat and per-protocol (PP) eradication rates were 75.2% and 81.1%, respectively. The PP eradication rates for the years 2003∼2004, 2005, 2006 and 2007∼2008 were 76.5%, 82.5%, 91.3% and 75%, respectively. There was no significant difference of the eradication rates according to gender, age and the duration of treatment. Yet the eradication rate of the chronic gastritis group (66.7%) was significantly lower than that of the peptic ulcer group (84.7%) (p=0.030).
Conclusions: There was no definite downward trend for the eradication rates of second-line quadruple therapy during the 6 year study period. However, the eradication rate in the recent 2 years guaranteed only a 75% cure rate and the
quadruple therapy was less effective for the patients with chronic gastritis. Therefore, a novel, more potent novel second-line regimen may be needed for the eradication of H. pylori.
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KEYWORD
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Helicobacter pylori, Eradication rate, Quadruple therapy
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