Korean J Helicobacter Up Gastrointest Res.  2015 Sep;15(3):147-154. 10.7704/kjhugr.2015.15.3.147.

Current Trends of Helicobacter pylori Eradication in Korea

Affiliations
  • 1Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. Keedon@amc.seoul.kr

Abstract

Helicobacter pylori infection is associated with an increased risk of upper gastrointestinal diseases, such as peptic ulcer disease, gastric cancer, and mucosa associated lymphoid tissue lymphoma. Since 1998, when regimens for H. pylori eradication were first recommended in Korea, the triple therapy of proton pump inhibitor, clarithromycin, and amoxicillin has been recommended as a primary regimen. Recently updated Korean guideline also recommends standard triple therapy as first-line regimen. Several studies have suggested that the effectiveness of the standard triple therapy based on clarithromycin has decreased over time. A recent meta-analysis of first-line triple therapy in Korea showed that the eradication rate decreased significantly from 1998 to 2013 (P<0.001 for both intention-to-treat and per-protocol analyses. The overall eradication rate were 74.6% (95% CI, 72.1~77.2%) by intention-to-treat analysis and 82.0% (95% CI, 80.8~83.2%) by per-protocol analysis. Alternative regimens (non-bismuth quadruple therapy; sequential or concomitant therapy, bismuth quadruple therapy, or levofloxacin containing quadruple therapy) can be considered as first-line therapy for H. pylori infection in Korea. Nation-wide surveillance data on the resistance pattern is needed to recommend an effective first-line regimen in Korea.

Keyword

Helicobacter pylori; Therapeutics; Korea

MeSH Terms

Amoxicillin
Bismuth
Clarithromycin
Gastrointestinal Diseases
Helicobacter pylori*
Helicobacter*
Korea*
Levofloxacin
Lymphoma, B-Cell, Marginal Zone
Peptic Ulcer
Proton Pumps
Stomach Diseases
Amoxicillin
Bismuth
Clarithromycin
Proton Pumps
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