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KMID : 0931320180180040242
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대한상부위장관.헬리코박터학회지
2018 Volume.18 No. 4 p.242 ~ p.246
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Optimal First-line Eradication Regimens for Helicobacter pylori Infection in Patients with Clarithromycin Resistance: A Pilot Study
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Seo Min-Woo
Jeong Yeon-Jeong
Kim Joon-Sung
Kim Byung-Wook
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Abstract
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Background/Aims: Helicobacter pylori eradication rates using first-line treatment have decreased due to clarithromycin resistance. The aim of this study was to investigate optimal eradication regimens for patients with clarithromycin resistance in Korea.
Materials and Methods: A total of 72 patients with confirmed clarithromycin resistance were enrolled from August 2015 to July 2017. Patients were randomized to a 7-day bismuth quadruple therapy (BQT) regimen or a 7-day metronidazole triple therapy (MTT) regimen. Eradication was confirmed using the 13C-urea breath test.
Results: There were no differences in baseline characteristics between the groups. Intention-to-treat eradication rates were 77.8% for the BQT group and 66.7% for the MTT group (P=0.293). Per protocol eradication rates were 87.5% for the BQT group and 77.4% for the MTT group (P=0.292). Adverse events were more frequent in the BQT group.
Conclusions: Eradication rates using MTT were comparable to those using BQT, and adverse events were less frequent in the MTT group. Thus, MTT may be considered as a first-line regimen for patients with clarithromycin resistance. Since this was a pilot study, a study with a large group is required.
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KEYWORD
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Clarithromycin, Helicobacter pylori, Metronidazole, Microbial drug resistance
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