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.
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

To explore new agents of quinolone derivatives with high activity against Gram-positive and Gram-negative microorganisms, 7-(3-amino-4-alkoxyimino-1-piperidyl) quinolones were designed and synthesized, and their activity against Gram-positive and Gram- negative microorganisms were tested in vivo and in vitro. Twenty one target compounds were obtained. Their structures were established by 1H NMR, HRMS and X-ray crystallographic analysis. The target compounds possess different antimicrobial activities against both Gram-negative and Gram-positive microorganisms. Compounds 14a and 14m have broad spectral antibacterial activities. They show better antibacterial activities against 12 strains Gram-positive bacteria than three references. In particular, their activities against S. aureus and S. epidermidis (including MRSA and MRSE) were 4 - 16 times than that of gemifloxacin and balofloxacin, and 8 - 64 times than that of levofloxacin. The MIC values to S. aureus strains of compounds 14a and 14m were 0.25 - 1 mg x L(-1) and 0.125 - 1 mg x L(-1), to S. epidermidis strains were 0.5 - 4 mg x L(-1) and 1 - 8 mg x L(-1) respectively. The in vivo results showed that they have as good internal protection as gemifloxacin and moxifloxacin against systemic infection model in mice (P > 0.05).
Animals ; Anti-Bacterial Agents ; chemical synthesis ; pharmacology ; therapeutic use ; Female ; Gram-Negative Bacteria ; drug effects ; Gram-Positive Bacteria ; drug effects ; Male ; Methicillin-Resistant Staphylococcus aureus ; drug effects ; Mice ; Microbial Sensitivity Tests ; Molecular Structure ; Pneumococcal Infections ; drug therapy ; Quinolones ; chemical synthesis ; pharmacology ; therapeutic use ; Random Allocation ; Staphylococcal Infections ; drug therapy

This multicenter study was undertaken to determine the efficacy of antibiotic prophylaxis and identify the risk factors for infectious complications after prostate surgery in Korean patients. A total of 424 patients who underwent surgery of the prostate were reviewed. All patients underwent urinalysis and urine culture preoperatively and postoperatively. Efficacy of antibiotic prophylaxis and risk factors for infectious complications were investigated. Infectious complications were observed in 34.9% of all patients. Factors independently associated with infectious complications were diabetes mellitus (adjusted OR, 1.99; 95% CI, 1.09-3.65, P=0.025) and operation time (adjusted OR, 1.08; 95% CI, 1.03-1.13, P=0.004). Clinicians should be aware of the high risk of infectious complications in patients with diabetes and those who undergo a prolonged operation time. Neither the type nor duration of prophylactic antibiotics resulted in differences in infectious complications.
Aged ; Anti-Bacterial Agents/pharmacology/therapeutic use ; Antibiotic Prophylaxis ; Diabetes Mellitus, Type 2/complications ; Drug Resistance, Bacterial/drug effects ; Enterococcus/drug effects/isolation & purification ; Escherichia coli/isolation & purification ; Humans ; Klebsiella pneumoniae/drug effects/isolation & purification ; Male ; Middle Aged ; Odds Ratio ; Postoperative Complications/microbiology/prevention & control ; Prospective Studies ; Prostatic Neoplasms/complications/*surgery ; Quinolones/pharmacology ; Risk Factors ; Time Factors ; Transurethral Resection of Prostate ; Urinalysis ; Urinary Tract Infections/microbiology