Korean J Gastrointest Endosc.  2006 Aug;33(2):63-68.

Comparison of the Eradication Rates of Quadruple Therapy between Non-ulcer Dyspepsia and Peptic Ulcer Disease as a Second-line Treatment for Helicobacter pylori Infection

• Chung SJ
• Lee DH
• Kim N
• Jung SH
• Kim JW
• Hwang JH
• Park YS
• Lee KH
• Jung HC
• Song IS

Abstract

BACKGROUND/AIMS: Initial PPI-based triple therapy for a Helicobacter pylori (H. pylori) infection is less effective in patients with non-ulcer dyspepsia (NUD) than in those with peptic ulcer disease (PUD). However, there are no reports of the effects of second-line treatment. We retrospectively analyzed the difference in the eradication rates of second-line quadruple therapy between NUD and PUD patients.
METHODS
Between June 2003 and September 2005, patients who failed to respond to the initial PPI-based triple therapy, received seven days bismuth-based quadruple therapy as a second-line treatment. Four to six weeks after completing the schedule, a 13C-urea breath test was performed to detect H. pylori.
RESULTS
A total of 87 patients received second-line quadruple therapy. Of these, 43 patients had NUD and 44 patients had PUD (19 with gastric ulcers, 23 with duodenal ulcers, 2 with both ulcers). The eradication rates were 76.7% (33/43) and 90.9% (40/44) in the NUD and PUD groups, respectively. The eradication rates in the NUD group were significantly lower than those in the PUD group (p=0.034).
CONCLUSIONS
The seven days bismuth-based second-line quadruple therapy for H. pylori infection appears to be less effective in patients with NUD than in those with PUD. Therefore, an extension of the treatment duration for quadruple therapy or a more potent regimen may be needed as a second-line therapy for NUD patients.

Keyword

Helicobacter pylori; Eradication; Dyspepsia; Peptic ulcer