Optimal First-line Eradication Regimens for Helicobacter pylori Infection in Patients with Clarithromycin Resistance: A Pilot Study

Background/Aims: Helicobacter pylori eradication rates using first-line treatment have decreased due to clarithromycin resistance. The aim of this study was to investigate optimal eradication regimens for patients with clarithromycin resistance in Korea. Materials and Methods: A total of 72 patients...

Full description

Saved in:
Bibliographic Details
Main Authors: Min Woo Seo, Yeon Jeong Jeong, Joon Sung Kim, Byung Wook Kim
Format: Article
Language:English
Published: Korean College of Helicobacter and Upper Gastrointestinal Research 2018-12-01
Series:The Korean Journal of Helicobacter and Upper Gastrointestinal Research
Subjects:
Online Access:http://www.helicojournal.org/journal/view.html?doi=10.7704/kjhugr.2018.18.4.242
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849396254116675584
author Min Woo Seo
Yeon Jeong Jeong
Joon Sung Kim
Byung Wook Kim
author_facet Min Woo Seo
Yeon Jeong Jeong
Joon Sung Kim
Byung Wook Kim
author_sort Min Woo Seo
collection DOAJ
description Background/Aims: Helicobacter pylori eradication rates using first-line treatment have decreased due to clarithromycin resistance. The aim of this study was to investigate optimal eradication regimens for patients with clarithromycin resistance in Korea. Materials and Methods: A total of 72 patients with confirmed clarithromycin resistance were enrolled from August 2015 to July 2017. Patients were randomized to a 7-day bismuth quadruple therapy (BQT) regimen or a 7-day metronidazole triple therapy (MTT) regimen. Eradication was confirmed using the ¹³C-urea breath test. Results: There were no differences in baseline characteristics between the groups. Intention-to-treat eradication rates were 77.8% for the BQT group and 66.7% for the MTT group (P=0.293). Per protocol eradication rates were 87.5% for the BQT group and 77.4% for the MTT group (P=0.292). Adverse events were more frequent in the BQT group. Conclusions: Eradication rates using MTT were comparable to those using BQT, and adverse events were less frequent in the MTT group. Thus, MTT may be considered as a first-line regimen for patients with clarithromycin resistance. Since this was a pilot study, a study with a large group is required.
format Article
id doaj-art-d9fe9144e7f94ebb99ed17660a846582
institution Kabale University
issn 1738-3331
language English
publishDate 2018-12-01
publisher Korean College of Helicobacter and Upper Gastrointestinal Research
record_format Article
series The Korean Journal of Helicobacter and Upper Gastrointestinal Research
spelling doaj-art-d9fe9144e7f94ebb99ed17660a8465822025-08-20T03:39:22ZengKorean College of Helicobacter and Upper Gastrointestinal ResearchThe Korean Journal of Helicobacter and Upper Gastrointestinal Research1738-33312018-12-0118424224610.7704/kjhugr.2018.18.4.242kjhugr.2018.18.4.242Optimal First-line Eradication Regimens for Helicobacter pylori Infection in Patients with Clarithromycin Resistance: A Pilot StudyMin Woo Seo0Yeon Jeong Jeong1Joon Sung Kim2Byung Wook Kim3Division of Gastroenterology, Department of Internal Medicine, Incheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Incheon, KoreaDivision of Gastroenterology, Department of Internal Medicine, Incheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Incheon, KoreaDivision of Gastroenterology, Department of Internal Medicine, Incheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Incheon, KoreaDivision of Gastroenterology, Department of Internal Medicine, Incheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Incheon, KoreaBackground/Aims: Helicobacter pylori eradication rates using first-line treatment have decreased due to clarithromycin resistance. The aim of this study was to investigate optimal eradication regimens for patients with clarithromycin resistance in Korea. Materials and Methods: A total of 72 patients with confirmed clarithromycin resistance were enrolled from August 2015 to July 2017. Patients were randomized to a 7-day bismuth quadruple therapy (BQT) regimen or a 7-day metronidazole triple therapy (MTT) regimen. Eradication was confirmed using the ¹³C-urea breath test. Results: There were no differences in baseline characteristics between the groups. Intention-to-treat eradication rates were 77.8% for the BQT group and 66.7% for the MTT group (P=0.293). Per protocol eradication rates were 87.5% for the BQT group and 77.4% for the MTT group (P=0.292). Adverse events were more frequent in the BQT group. Conclusions: Eradication rates using MTT were comparable to those using BQT, and adverse events were less frequent in the MTT group. Thus, MTT may be considered as a first-line regimen for patients with clarithromycin resistance. Since this was a pilot study, a study with a large group is required.http://www.helicojournal.org/journal/view.html?doi=10.7704/kjhugr.2018.18.4.242ClarithromycinHelicobacter pyloriMetronidazoleMicrobial drug resistance
spellingShingle Min Woo Seo
Yeon Jeong Jeong
Joon Sung Kim
Byung Wook Kim
Optimal First-line Eradication Regimens for Helicobacter pylori Infection in Patients with Clarithromycin Resistance: A Pilot Study
The Korean Journal of Helicobacter and Upper Gastrointestinal Research
Clarithromycin
Helicobacter pylori
Metronidazole
Microbial drug resistance
title Optimal First-line Eradication Regimens for Helicobacter pylori Infection in Patients with Clarithromycin Resistance: A Pilot Study
title_full Optimal First-line Eradication Regimens for Helicobacter pylori Infection in Patients with Clarithromycin Resistance: A Pilot Study
title_fullStr Optimal First-line Eradication Regimens for Helicobacter pylori Infection in Patients with Clarithromycin Resistance: A Pilot Study
title_full_unstemmed Optimal First-line Eradication Regimens for Helicobacter pylori Infection in Patients with Clarithromycin Resistance: A Pilot Study
title_short Optimal First-line Eradication Regimens for Helicobacter pylori Infection in Patients with Clarithromycin Resistance: A Pilot Study
title_sort optimal first line eradication regimens for helicobacter pylori infection in patients with clarithromycin resistance a pilot study
topic Clarithromycin
Helicobacter pylori
Metronidazole
Microbial drug resistance
url http://www.helicojournal.org/journal/view.html?doi=10.7704/kjhugr.2018.18.4.242
work_keys_str_mv AT minwooseo optimalfirstlineeradicationregimensforhelicobacterpyloriinfectioninpatientswithclarithromycinresistanceapilotstudy
AT yeonjeongjeong optimalfirstlineeradicationregimensforhelicobacterpyloriinfectioninpatientswithclarithromycinresistanceapilotstudy
AT joonsungkim optimalfirstlineeradicationregimensforhelicobacterpyloriinfectioninpatientswithclarithromycinresistanceapilotstudy
AT byungwookkim optimalfirstlineeradicationregimensforhelicobacterpyloriinfectioninpatientswithclarithromycinresistanceapilotstudy