Journal List > Korean J Gastroenterol > v.58(2) > 1006905

Kim and Jung: Helicobacter pylori Eradication Therapy in Korea

Abstract

Helicobacter pylori (H. pylori) is known to be associated with many gastrointestinal diseases including peptic ulcer. In Korea, eradication of H. pylori is recommended for peptic ulcer disease, low grade gastric mucosa-associated lymphoid tissue lymphoma, and early gastric cancer. Standard triple therapy using proton pump inhibitor, clarithromycin, and amoxicillin and bismuth-containing quadruple therapy have been the main first-line and second-line therapy for H. pylori in Korea. Although eradication rate of second-line quadruple therapy remains similar to that of the past, the success rate of eradication with triple therapy has decreased with increasing antimicrobial resistance to H. pylori. There is no standard third-line therapy, and some regimens that incorporate levofloxacin, moxifloxacin, and rifabutin can be used. New regimens such as sequential or concomitant therapy are suggested as alternative treatment for H. pylori. We need more well designed randomized controlled studies to choose proper treatment for H. pylori infection.

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Fig. 1.
The change of per protocol eradication rates of standard triple therapy in Korea.11,14-18 Studies maked with ∗ showed significant decreasing trend of eradication rate.
kjg-58-67f1.tif
Fig. 2.
The change of per protocol eradication rates of second-line bismuth-containing quadruple therapy in Korea.11,16,18,30 There was no decreasing trend in eradication rates.
kjg-58-67f2.tif
Table 1.
Indication for Helicobacter pylori Eradication
Definite indication
 1) Peptic ulcer including scar
 2) Marginal Zone B cell lymphoma (MALT type) a
 3) Early gastric cancer
Recommended indication
 1) First relatives of gastric cancer patients
 2) Unexplained iron deficiency anemia
 3) Chronic idiopathic thrombocytopenic purpura
Possible indication
 1) Atrophic gastritis
 2) Non-ulcer dyspepsia
 3) Long-term use of NSAID

MALT, mucosa-associated lymphoid tissue.

a Low grade MALToma has been renamed as Marginal zone B cell lymphoma (MALT type).

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