New Helicobacter pylori Eradication Therapies

Jae Yong Park; Jae Gyu Kim

doi:10.4166/kjg.2018.72.5.237

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Park and Kim: New Helicobacter pylori Eradication Therapies

Review Article

The Korean Journal of Gastroenterology 2018; 72(5): 237-244.

Published online: 28 November 2018

DOI: https://doi.org/10.4166/kjg.2018.72.5.237

New Helicobacter pylori Eradication Therapies

Jae Yong Park, Jae Gyu Kim

Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Korea.

Correspondence to: Jae Gyu Kim, Department of Internal Medicine, Chung-Ang University College of Medicine, 102 Heukseok-ro, Dongjak-gu, Seoul 06973, Korea. Tel: +82-2-6299-3147, Fax: +82-2-749-9150, jgkimd@cau.ac.kr

Received 1 October 2018 Revised 20 October 2018 Accepted 29 October 2018

Korean Society of Gastroenterology

(open-access):

This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

While the prevalence of Helicobacter pylori (H. pylori) infection is decreasing in Korea, the incidence of gastric cancer remains high, emphasizing the importance of H. pylori eradication. A new treatment strategy is needed as the eradication rate with standard triple therapy, which is currently the standard first-line regimen for H. pylori infection, has decreased below the optimum level. The major cause of eradication failure is increased antibiotic resistance. Sequential, concurrent, and hybrid therapies that include clarithromycin produce higher eradication rates than conventional standard triple therapy. However, the effectiveness of these treatments is limited in regions where the resistance rate to various antibiotics is high. Bismuth quadruple therapy is another alternative therapy, but again the eradication rate is not sufficiently high. Tailored therapy based on individual characteristics, including antibiotic susceptibility, may be ideal, but there are several limitations for clinical application and further research is needed. New potassium-competitive acid blocker-based therapies could emerge as effective alternatives in the near future. A consensus is needed to establish a strategy for applying new eradication therapies in Korea.

Keywords: Helicobacter pylori, Therapeutics, Guideline, Korea

Figures and Tables

Fig. 1

A treatment scheme for Helicobacter pylori infection. STT, standard triple therapy; BQT, bismuth-containing quadruple therapy. ^aDue to paucity of data regarding the efficacy of BQT as a first-line therapy or rescue therapy after sequential/concomitant therapy, there might be controversy in choosing this regimen.

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ORCID iDs: Jae Gyu Kim
https://orcid.org/0000-0002-4841-9404
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