Korean J Gastroenterol.  2005 Aug;46(2):94-98.

The Trend of Eradication Rates of Second-Line Quadruple Therapy Containing Metronidazole for Helicobacter pylori Infection: An Analysis of Recent Eight Years

Affiliations
  • 1Department of Internal Medicine, Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea. hyunchae@plaza.snu.ac.kr
  • 2Seoul National University Hospital Health Care System, Seoul, Korea.
  • 3Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
  • 4Department of Microbiology and Institute of Biomedical Science, Hanyang University College of Medicine, Seoul, Korea.

Abstract

BACKGROUND/AIMS: Failure rates of Helicobacter pylori eradication treatment turned out to be exceeding 10%, causing recurrence of peptic ulcers. In the case of eradication failure, the Korean College of Helicobacter Research and Practice recommends quadruple therapy consisting of proton pump inhibitor, bismuth, tetracycline and metronidazole. Many reports regarding the eradication rates of quadruple therapy have been reported. However, most were limited by short follow-up periods. Hence, we evaluated the efficacy of the metronidazole containing quadruple therapy as a second line treatment from April, 1996 through July, 2004. METHODS: Sixty-three patients were enrolled. Treatment consisted of aforementioned quadruple therapy for 1 week. Four to six weeks after completion of treatment, biopsies and CLO tests were performed to detect the presence of H. pylori. The patients were then followed-up with upper endoscopy once every year. RESULTS: The efficacy of the quadruple therapy was 74.6% in intention-to-treat analysis and 83.9% in per protocol analysis. Eradication rates of the years 1996, 1999-2000, 2001, and 2002-2004 were 75.0%, 93.8%, 100%, and 72.7%, respectively. CONCLUSIONS: Our data can not reveal the evidence of decreasing trend for eradication rate quadruple therapy of H. pylori in 8 years. However, eradication rate of 72.7% in recent 2 years necessitates the development of more efficient eradication regimen.

Keyword

Helicobacter pylori; Metronidazole; Quadruple therapy; Eradication rate

MeSH Terms

Adult
Antacids/administration & dosage
Anti-Infective Agents/*administration & dosage
Bismuth/administration & dosage
Drug Therapy, Combination
English Abstract
Female
Helicobacter Infections/*drug therapy
*Helicobacter pylori
Humans
Male
Metronidazole/*administration & dosage
Middle Aged
Peptic Ulcer/microbiology
Proton Pumps/antagonists & inhibitors
Recurrence
Tetracycline/administration & dosage
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