The Korean journal of helicobacter and upper gastrointestinal research (대한상부위장관⦁헬리코박터학회지)

Korean College of Helicobacter and upper Gastrointestinal Reseaarch (대한상부위장관ㆍ헬리코박터학회)
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Optimal First-line Eradication Regimens for Helicobacter pylori Infection in Patients with Clarithromycin Resistance: A Pilot Study

국내 클래리스로마이신 내성균에서 가장 효과적인 헬리코박터 제균 치료법

  • Seo, Min Woo (Division of Gastroenterology, Department of Internal Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea) ;
  • Jeong, Yeon Jeong (Division of Gastroenterology, Department of Internal Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea) ;
  • Kim, Joon Sung (Division of Gastroenterology, Department of Internal Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea) ;
  • Kim, Byung Wook (Division of Gastroenterology, Department of Internal Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea)
  • 서민우 (가톨릭대학교 의과대학 내과학교실 인천성모병원 소화기내과) ;
  • 정연정 (가톨릭대학교 의과대학 내과학교실 인천성모병원 소화기내과) ;
  • 김준성 (가톨릭대학교 의과대학 내과학교실 인천성모병원 소화기내과) ;
  • 김병욱 (가톨릭대학교 의과대학 내과학교실 인천성모병원 소화기내과)
  • Received : 2018.08.22
  • Accepted : 2018.10.03
  • Published : 2018.12.31
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Abstract

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 $^{13}C$-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.

Keywords

Acknowledgement

Supported by : Korean College of Helicobacter and Upper Gastrointestinal Research Foundation

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Cited by

  1. Eradication Therapy for Helicobacter pylori with Diagnostic Test for Clarithromycin Resistance vol.19, pp.4, 2019, https://doi.org/10.7704/kjhugr.2019.0019