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KMID : 0882420090760030303
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Korean Journal of Medicine
2009 Volume.76 No. 3 p.303 ~ p.310
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Trend in the eradication rates of Helicobacter pylori infection in the last 11 years
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Song Jong-Gyu
Lee Sang-Woo
Park Jin-Yong
Nam Seung-Joo
Kim Seung-Young
Ahn Jae-Hong
Kim Jin-Nam
Park Sun-Min
Kim Jeong-Han
Kim Dong-Il
Jung Sung-Woo
Koo Ja-Seol
Yim Hyung-Joon
Park Jong-Jae
Chun Hoon-Jai
Lee Hong-Sik
Choi Jai-Hyun
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Abstract
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Background/Aims: The standard triple therapy used as the first-line treatment for Helicobacter pylori that combines a proton pump inhibitor (PPI), amoxicillin, and clarithromycin had an initial eradication rate of 90%. However, many recent studies have not found this level of effectiveness. This study evaluated the trend in the eradication rates of H. pylori infection over the last 11 years.
Methods: This was a retrospective study of patients diagnosed with H. pylori infection between 1997 and 2007 and treated with triple therapy (PPI, amoxicillin, and clarithromycin). The patients answered questions about compliance and side effects within 2 weeks of completing their treatment. In addition, we assessed whether the H. pylori had been eradicated at least 4 weeks after the treatment using a 13C-urea breath test, rapid urease test, or histopathological examination.
Results: The eradication rate with first-line triple therapy decreased over the study period. There was no change in the eradication rate with second-line quadruple therapy (PPI, bismuth, metronidazole, and tetracycline). There were no differences in the eradication rate and recrudescence between 1- and 2-week regimens.
Conclusions: The effectiveness of the recommended first-line triple therapy for H. pylori eradication has decreased significantly in the last decade. Therefore, the first-line therapy based on the combination of PPI, amoxicillin and clarithromycin may need to be changed in the near future.
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KEYWORD
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Helicobacter pylori, Eradication rate, Triple therapy
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