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KMID : 0931320210210010035
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대한상부위장관.헬리코박터학회지
2021 Volume.21 No. 1 p.35 ~ p.47
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Eradication Rates of Clarithromycin Triple Therapy in Korea: A Systematic Review and Meta-analysis
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Kang Seung-Joo
Jung Hye-Kyung
Lee Yong-Chan
Yang Hyo-Joon
Park Seon-Young
Shin Cheol-Min
Kim Sung-Eun
Lim Hyun-Chul
Kim Jie-Hyun
Nam Su-Youn
Shin Woon-Geon
Park Jae-Myung
Choi Il-Ju
Kim Jae-Gyu
Choi Mi-Young
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Abstract
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Background/Aims: Standard triple therapy, including a proton pump inhibitor, clarithromycin, and amoxicillin, has been recommended as the first-line for Helicobacter pylori infection. However, the eradication rate of standard triple therapy has declined over the past years because of the increasing resistance to clarithromycin in Korea. We analyzed the eradication rates and the 10-year change in the eradication rates in Korea.
Methods: PubMed, EMBASE, the Cochrane Library, and KoreaMed were searched for studies published between January 2007 and June 2018. The pooled eradication rates and their 95% CIs were estimated using a random-effect logistic regression model.
Results: Twenty-six randomized controlled studies on standard triple therapy conducted in Korea were selected. The intention-to-treat (ITT) and per protocol analyses showed pooled eradication rates of standard triple therapy of 71.6% (95% CI, 69.9~73.3%) and 79.6% (95% CI, 76.6~82.2%), respectively. The eradication rate decreased with time. The ITT analysis showed that the 14-day therapy (78.1% [95% CI, 75.2~80.7%]) had significantly higher eradication rates than the 7-day therapy (70.0% [95% CI, 68.5~71.4%]) (P<0.01).
Conclusions: These results suggest that the eradication rate of standard triple therapy, as the first-line therapy, has shown an unacceptable decrease. The eradication rate increased when the duration of therapy was increased to 14 days, but it was not satisfactory. Therefore, other treatment regimens or therapies based on susceptibility tests should be considered for the first-line therapy.
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KEYWORD
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Clarithromycin, Disease eradication, Helicobacter pylori, Meta-analysis
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