Comparison of the Efficacy of Bismuth Containing PPI-based Quadruple Therapy with PPI-based Triple Therapy Only as First-line Treatment for <I>Helicobacter pylori</I> Infection

Korean J Gastrointest Endosc > Volume 37(4); 2008 > Article

Korean Journal of Gastrointestinal Endoscopy 2008;37(4): 259-264.

Helicobacter pylori 1차 치료시 삼제요법과 Bismuth 포함 사제요법에서의 제균율 비교

조현진ㆍ이동호*ㆍ강승주ㆍ김미나ㆍ김수현ㆍ박진명ㆍ최문선ㆍ정현채ㆍ송인성ㆍ김나영*ㆍ정숙향*ㆍ김진욱*ㆍ박영수*ㆍ이상협*

서울대학교 의과대학 내과학교실, 간연구소, *분당서울대학교병원 내과

Comparison of the Efficacy of Bismuth Containing PPI-based Quadruple Therapy with PPI-based Triple Therapy Only as First-line Treatment for Helicobacter pylori Infection

Hyun Jin Jo, M.D., Dong Ho Lee, M.D.*, Seung Joo Kang, M.D., Mi Na Kim, M.D., Su Hyun Kim, M.D., Jin Myung Park, M.D., Mun Sun Choi, M.D., Hyun Chae Jung, M.D., In Sung Song, M.D., Nayoung Kim, M.D.*, Sook Hyang Jung, M.D.*, Jin Wook Kim, M.D.*, Young Soo

Department of Internal Medicine and the Liver Research Institute, Seoul National University College of Medicine, Seoul, *Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea

Abstract

Background/Aims:
In recent years, increasing antimicrobial resistance has resulted in falling eradication rates with standard therapies. To overcome the falling eradication rates, rescue therapy have been suggested to be used. However, there is no surveillance of using bismuth- based regimen as first line Helicobacter pylori eradication therapy in Korea. This study aimed to assess the efficacy of bismuth containing PPI-based quadruple therapy as a first line treatment.
Methods:
From August 2007 through February 2008, 191 patients with Helicobacter pylori positive peptic ulcer disease (PUD) or chronic gastritis (CG) who received first line therapy for 7 days were retrospectively evaluated. 39, 37, 53, 62 patients received PAC (pantoprazole 40 mg, amoxicillin 1 g, clarithromycin 500 mg bid), L-PAC (pantoprazole 40 mg, amoxicillin 750 mg, clarithromycin 250 mg bid), PACB (PAC plus bismuth 300 mg bid), L-PACB (L-PAC plus bismuth 300 mg bid).
Results:
There was no significant difference in eradication rates between bismuth containing and non- containing group. However, in PUD, the eradication rate of PACB (95.2%) is somewhat higher than that of PAC (86.2%) without statistical significance.
Conclusions:
In PUD, Future study designed with a double-blind controlled large scale might reveal that PPI-based standard quadruple therapy containing a bismuth is superior to the standard triple therapy. (Korean J Gastrointest Endosc 2008;37: 259-264)

Key Words: Helicobacter pylori, First-line treatment, Bismuth, Peptic ulcer disease

주요어: Helicobacter pylori, 1차 제균 치료, Bismuth, 소화성 궤양