Historical Perspective of Helicobacter pylori Treatment in Korea.
10.7704/kjhugr.2015.15.4.211
- Author:
Jong Yeul LEE
1
;
Ji Yong AHN
;
Il Ju CHOI
Author Information
1. Center for Gastric Cancer, National Cancer Center Hospital, Goyang, Korea. cij1224@ncc.re.kr
- Publication Type:Meta-Analysis ; Review
- Keywords:
Anti-bacterial agents;
Drug resistance;
Helicobacter pylori;
Therapy
- MeSH:
Amoxicillin;
Anti-Bacterial Agents;
Clarithromycin;
Drug Resistance;
Drug Resistance, Microbial;
Helicobacter pylori*;
Helicobacter*;
Korea*;
Multicenter Studies as Topic;
Peptic Ulcer;
Prospective Studies;
Proton Pumps;
Rifabutin;
Risk Factors;
Stomach Neoplasms
- From:The Korean Journal of Helicobacter and Upper Gastrointestinal Research
2015;15(4):211-221
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Since the discovery of Helicobacter pylori in 1983 by Warren and Marshall, it has been recognized as one of the most significant risk factors for gastric cancer and has been associated with various gastrointestinal disorders such as peptic ulcer disease. In Korea, the triple therapy of proton pump inhibitor, clarithromycin, and amoxicillin has been recommended as a primary regimen since 1998. However, the eradication rate of conventional first line therapy of H. pylori infection has been decreasing progressively, primarily due to increased resistance to antibiotics. A recent meta-analysis showed that the overall eradication rates were 74.6% by intention-to-treat analysis and 82.0% by per-protocol analysis. Therefore, the need for alternative first line eradication regimens has been rising. Sequential therapy, concomitant therapy, and various combinations of new antibiotics such as quinolone and rifabutin have been introduced as new options, but they have yet to be proven as standard first line therapy. Further nation-wide surveillance regarding the antibiotic resistance rates and well-designed prospective randomized controlled multicenter trials on the empirical first line therapy are necessary to establish the appropriate treatment for H. pylori in Korea.