Korean J Gastroenterol.  2014 Mar;63(3):158-170. 10.4166/kjg.2014.63.3.158.

Future Trends of Helicobacter pylori Eradication Therapy in Korea

• Lee JY
• Kim N

• KMID: 1730927
• DOI: http://doi.org/10.4166/kjg.2014.63.3.158

Abstract

The prevalence of Helicobacter pylori infection in Korea shows a decreasing trend and has changed to that of developed country, especially for those below 30 years old. However, the primary antibiotic resistance rates are higher than those of developed countries. The reason for the decrease in the efficacy of standard triple therapy is mainly due to the increase in the resistance against clarithromycin. Sequential therapy seems to be more effective than the standard triple therapy, but the intention-to-treat eradication rate of sequential therapy in Korea, which is mostly under 80.0%, is still not satisfactory. Therefore, a promising regimen is needed. Recently, the Japanese health insurance system admitted 'H. pylori-infected gastritis' as an indication of eradication. Furthermore, the Kyoto Consensus Meeting on H. pylori Gastritis held from January 30th to February 1st, 2014, proposed that 'all H. pylori positive patients should be offered to receive H. pylori eradication'. This suggests that the concept of eradication has been changed from 'treatment' to 'prevention'. Various individualized tailored therapy based on the polymorphism, age and other demographic factors and antibiotic resistance has been attempted to maximize H. pylori eradication therapy. The aim of this article is to review the current epidemiology, H. pylori resistance state, treatment guideline, and to assess the possible future strategy and treatment for H. pylori infection in Korea.

Keyword

Helicobacter pylori; Guidelines; Treatment; Prevention

MeSH Terms

Anti-Bacterial Agents/pharmacology/*therapeutic use
Aryl Hydrocarbon Hydroxylases/genetics/metabolism
Clarithromycin/pharmacology/therapeutic use
Disease Eradication/trends
Drug Resistance, Bacterial
Drug Therapy, Combination
Guidelines as Topic
Helicobacter Infections/*drug therapy/epidemiology
*Helicobacter pylori/drug effects
Humans
Quinolones/pharmacology/therapeutic use
Republic of Korea
Treatment Failure
Anti-Bacterial Agents
Aryl Hydrocarbon Hydroxylases
Clarithromycin
Quinolones

Figure

• 

  Fig. 1. Comparison of prevalence rate of Helicobacter pylori infection among China, Korea, and Japan. (A) Prevalence (using urea breath test or serum IgG antibody) by age in 2004–2005 in Jiangsu, China and in 2003 in Beijing, China.14,15 (B) Seroprevalence in asymptomatic subjects without a history of H. pylori eradication in 1998, 2005, and 2011 in Korea.16–18 (C) Prevalence (using urine antibody or serum IgG antibody) of H. pylori in 1992, 2002–2006, and 2007–2011 in Japan.19–21 Reused from the article of Shiota, et al. (Expert Rev Gastroenterol Hepatol 2013;7:35–40)21 with original copyright holder' s permission.

• 

  Fig. 2. The mean intention-to-treat (ITT) eradication rate for sequential therapy reported after 2008 in Europe (Italy,74–79 Spain78,79), Korea,82 and Asia (China, Taiwan, India, and Iran).82

Reference

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