Clinical Factors That Potentially Affect the Treatment Outcome of Helicobacter pylori Eradication Therapy with using a Standard Triple Regimen in Peptic Ulcer Patients
Taek Man Nam, M.D., Dong Ho Lee, M.D., Kyung Phil Kang, M.D., Jung Hoon Lee, M.D., Jae Il Chung, M.D., Hyun Cheul Choi, M.D., Sang Hyub Lee, M.D., Young Soo Park, M.D., Jin Hyeok Hwang, M.D., Jin Wook Kim, M.D., Sook Hyang Jung, M.D., Nayoung Kim, M.D., H
Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, *Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
Abstract
Background/Aims: Proton pump inhibitor (PPI) based triple therapy for Helicobacter pylori eradication has an approximately 20% treatment failure rate. The aim of this study is to examine the clinical factors that influence eradication of H. pylori in patients with peptic ulcers. Methods: We reviewed the medical records of 597 endoscopy-proven peptic ulcer and H. pylori-positive patients who were treated at our hospital between July 2004 and March 2007. The eradication rate and the effect of age, gender, smoking, alcohol drinking, activity and the location of ulcer and the kind of PPIs were examined. Results: 597 patients were treated with one-week triple therapy (PPI, amoxicillin 1 g, clarithromycin 500 mg all twice daily). The overall eradication rate was 80.2%. Eradication was significantly more successful in the patients with an age under 60, and in patients over 60 and who had a duodenal ulcer (83.2% vs 73.2%, respectively, p=0.005) or a gastric ulcer (82.5% vs 73.6%, respectively, p=0.041). There was no statistically significant difference according to gender, smoking, alcohol, the activity of the ulcer and the kind of PPIs. Conclusions: An age over 60 and gastric ulcer were associated with a lower H. pylori eradication rate in patients with peptic ulcers. Therefore, H. pylori eradication in old age patients and in patients with gastric ulcer should be managed differently and the treatment duration should be extended or a new treatment regime developed to overcome the lower eradication rate. (Korean J Gastrointest Endosc 2008;36:199-205)
PDF Links
Full text via DOI 
Download Citation 
