The trends of one-week first-line and second-line eradication therapy for Helicobacter pylori infection in Korea

Hepatogastroenterology. 2011 Jan-Feb;58(105):246-50.

Abstract

Background/aims: Increasing levels of bacterial antibiotic resistance raise the need to assess the eradication efficiency of Helicobacter pylori. The aim of this study was to evaluate 7-year changes in efficacy of one-week first line and second line therapies in Helicobacter pylori eradication rates in Korea.

Methodology: From 2001 to 2007, 4198 Helicobacter pylori-positive patients received first-line therapy (proton pump inhibitor, amoxicillin 1,000 mg b.i.d., and clarithromycin 500 mg b.i.d.). Four hundred ninety patients received second-line therapy (proton pump inhibitor twelve hourly, metronidazole 500 mg t.i.d., tetracycline 500 mg q.i.d., and bismuth 300 mg q.i.d.). A 13C-urea breath test was used to determine the eradication rate.

Results: The eradication rates of first-line therapy were 81.3%, 83.7%, 80.1%, 80.7%, 82.0%, 75.9%, and 77.5% from 2001 to 2007, with a decreasing trend (p < 0.01). The eradication rate of second-line therapy was 77.3%, 86.2%, 95.6%, 95.9%, 89.6%, 83.2%, and 86.4% from 2001 to 2007 without decreasing trend (p = 0.26).

Conclusions: The eradication rate of first-line therapy has decreased in the last 7 years while that of second-line therapy has remained the same. A new strategy is required to improve the first-line therapy for Helicobacter pylori eradication in Korea.

Publication types

  • Comparative Study

MeSH terms

  • Amoxicillin / therapeutic use*
  • Bismuth / therapeutic use*
  • Breath Tests
  • Clarithromycin / therapeutic use*
  • Drug Resistance, Bacterial
  • Drug Therapy, Combination
  • Helicobacter Infections / diagnosis
  • Helicobacter Infections / drug therapy*
  • Helicobacter Infections / epidemiology
  • Helicobacter pylori*
  • Humans
  • Metronidazole / therapeutic use*
  • Practice Patterns, Physicians' / trends*
  • Proton Pump Inhibitors / therapeutic use*
  • Republic of Korea / epidemiology
  • Tetracycline / therapeutic use*
  • Treatment Outcome

Substances

  • Proton Pump Inhibitors
  • Metronidazole
  • Amoxicillin
  • Tetracycline
  • Clarithromycin
  • Bismuth