Future Trends of Helicobacter pylori Eradication Therapy in Korea.
10.4166/kjg.2014.63.3.158
- Author:
Ju Yup LEE
1
;
Nayoung KIM
Author Information
1. Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea. nayoungkim49@empas.com
- Publication Type:Review ; English Abstract
- Keywords:
Helicobacter pylori;
Guidelines;
Treatment;
Prevention
- MeSH:
Anti-Bacterial Agents/pharmacology/*therapeutic use;
Aryl Hydrocarbon Hydroxylases/genetics/metabolism;
Clarithromycin/pharmacology/therapeutic use;
Disease Eradication/trends;
Drug Resistance, Bacterial;
Drug Therapy, Combination;
Guidelines as Topic;
Helicobacter Infections/*drug therapy/epidemiology;
*Helicobacter pylori/drug effects;
Humans;
Quinolones/pharmacology/therapeutic use;
Republic of Korea;
Treatment Failure
- From:The Korean Journal of Gastroenterology
2014;63(3):158-170
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
The prevalence of Helicobacter pylori infection in Korea shows a decreasing trend and has changed to that of developed country, especially for those below 30 years old. However, the primary antibiotic resistance rates are higher than those of developed countries. The reason for the decrease in the efficacy of standard triple therapy is mainly due to the increase in the resistance against clarithromycin. Sequential therapy seems to be more effective than the standard triple therapy, but the intention-to-treat eradication rate of sequential therapy in Korea, which is mostly under 80.0%, is still not satisfactory. Therefore, a promising regimen is needed. Recently, the Japanese health insurance system admitted 'H. pylori-infected gastritis' as an indication of eradication. Furthermore, the Kyoto Consensus Meeting on H. pylori Gastritis held from January 30th to February 1st, 2014, proposed that 'all H. pylori positive patients should be offered to receive H. pylori eradication'. This suggests that the concept of eradication has been changed from 'treatment' to 'prevention'. Various individualized tailored therapy based on the polymorphism, age and other demographic factors and antibiotic resistance has been attempted to maximize H. pylori eradication therapy. The aim of this article is to review the current epidemiology, H. pylori resistance state, treatment guideline, and to assess the possible future strategy and treatment for H. pylori infection in Korea.
