Retreatment of Helicobacter pylori Infection with Triple Therapy after Initial Treatment Failure.
- Author:
Nayoung KIM
1
;
Seon Hee LIM
;
Kye Heui LEE
;
Myung Sook KOO
;
Jung Mogg KIM
;
Jin Hyeok HWANG
;
Jin Wook KIM
;
Dong Ho LEE
;
Hyun Chae JUNG
;
In Sung SONG
Author Information
1. Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea. nayoungkim49@yahoo.co.kr
- Publication Type:Original Article ; English Abstract
- Keywords:
Helicobacter pylori;
Triple therapy;
Treatment failure;
Retreatment
- MeSH:
Adult;
Anti-Bacterial Agents/*administration & dosage;
Anti-Ulcer Agents/*administration & dosage;
Drug Therapy, Combination;
Helicobacter Infections/*drug therapy;
*Helicobacter pylori;
Humans;
Male;
Middle Aged;
Peptic Ulcer/*drug therapy/microbiology;
Retreatment
- From:The Korean Journal of Gastroenterology
2003;42(3):195-203
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND/AIMS: Helicobacter pylori (H. pylori) treatments fail at least in 10-20% of patients. However, retreatment strategies after failure of initial treatment have not been established. This study was conducted to evaluate the eradication rate of retreatment choices. METHODS: Twenty-seven peptic ulcer patients who were retreated with OAC (omeprazole + amoxicillin + clarithromycin) or BMT (bismuth + metronidazole + tetracycline) after failure of BMT or OAC were included. Quadruple therapy (omeprazole + BMT) was also tried after failure of two successive triple therapies. Furthermore, the effect of resistance of metronidazole or clarithromycin on the eradication of H. pylori was evaluated. RESULTS: Among 13 patients who were retreated with OAC after failure of BMT regimen, H. pylori was eradicated in 10 patients (76.9%). Among 14 patients retreated with BMT after failure of OAC regimen, H. pylori was eradicated in 11 patients (78.6%). Resistance of H. pylori to metronidazole or clarithromycin decreased the efficacy of BMT or OAC, respectively. CONCLUSIONS: Eradication regimen should be decided considering the resistance to H. pylori. However, in case of unknown state of resistance, OAC can be chosen if BMT fails. Similarly, BMT can be tried in cases that OAC therapy failed. After failures of both triple therapies, quadruple therapy can be tried as the next step.
