Helicobacter pylori, Eradication rate, Quadruple therapy"/>
Recent Trends in the Eradication Rates of Second-Line Quadruple Therapy for Helicobacter Pylori and the Clinical Factors that Potentially Affect the Treatment Outcome
Recent Trends in the Eradication Rates of Second-Line Quadruple Therapy for Helicobacter Pylori and the Clinical Factors that Potentially Affect the Treatment Outcome
Eun Ju Cho, M.D., Dong Ho Lee, M.D.*, Jae Young Chun, M.D., Jong Kyung Choi, M.D., Sung Wook Hwang, 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.*, Hyun Chae Jung,
Department of Internal Medicine, College of Medicine, Seoul National University, Seoul, *Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
Abstract
Background/Aims: The present study aimed to evaluate the efficacy of second-line quadruple therapy for treating patients with Helicobacter Pylori, and these patients were treated at our hospitals for September, 2003 through April, 2008 in Seongnam, Korea.
Methods: One hundred and thirty-three patients who failed to respond to the initial PPI-based triple therapy received quadruple therapy, whcih consisted of PPI, bismuth, tetracycline and metronidazole. The patients were divided into two groups. One group was treated for 7 days and the other group was treated for 14 days. Four to six weeks after completing the schedule, a 13C-urea breath test was performed to detect the presence of H. pylori.
Results: The overall intention-to-treat and per-protocol (PP) eradication rates were 75.2% and 81.1%, respectively. The PP eradication rates for the years 2003∼2004, 2005, 2006 and 2007∼2008 were 76.5%, 82.5%, 91.3% and 75%, respectively. There was no significant difference of the eradication rates according to gender, age and the duration of treatment. Yet the eradication rate of the chronic gastritis group (66.7%) was significantly lower than that of the peptic ulcer group (84.7%) (p=0.030).
Conclusions: There was no definite downward trend for the eradication rates of second-line quadruple therapy during the 6 year study period. However, the eradication rate in the recent 2 years guaranteed only a 75% cure rate and the quadruple therapy was less effective for the patients with chronic gastritis. Therefore, a novel, more potent novel second-line regimen may be needed for the eradication of H. pylori.(Korean J Gastrointest Endosc 2009;38:14-19)
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