Pooled Analysis of Antibiotic Therapy for Helicobacter pylori Eradication in Korea

Kim, Byung Wook; Choi, Myung Gyu; Moon, Sung Bae; Kim, Bo Kyoung; Chae, Hiun Suk; Kim, Jae Kwang; Chung, In Sik; Sun, Hee Sik; Park, Doo Ho

Abstract

BACKGROUND/AIMS: We aimed to identify the ideal regimen for Helicobacter pylori (H. pylori) eradication in Korea.
METHODS
We analyzed the reports on H. pylori eradication published in Korea from June 1991 to July 1998. We included only the reports containing defined protocols and therapeutic regimens, clinical records of at least 15 adult patients with peptic ulcer for each regimen, and assessment of eradication rates taken 4 weeks or more after completion of therapy. Intention-to-treat analysis (ITT) and per-protocol analysis (PPA) were performed. Compliance and side effects were evaluated.
RESULTS
Seven (53.8%) among 13 full articles and 7 (26.9%) among 26 abstracts satisfied the requisite inclusion criteria. Eradication rates of proton pump inhibitor (PPI) based triple 7-day regimen which was consistent with consensus guidelines were 80.6% (range 53.2-93.1%) by ITT and 90.0% (range 85.2-93.1%) by PPA. There was no statistical significance among the treatment durations (7, 10, 14 days) of PPI-based therapies. Compliance was higher in PPI-based regimens than in bismuth-based regimens (p=0.018). Side effects could not be evaluated because they were not clearly appeared in the reports.
CONCLUSIONS
Reports which followed the consensus guidelines were rare. PPI-based triple 7-day regimen was consistent with consensus guidelines, but it is still unclear whether this regimen was ideal therapy for eradication of H. pylori in Korea. Seven days of duration may be enough for PPI based triple regimen. The studies on H. pylori eradication should follow the consensus guidelines.