Current Status and Treatment of Helicobacter pylori Infection in Korea

Lee, Dong Ho

Abstract

The seroprevalance of Helicobacter pylori (H. pylori) infection in Korea is relatively high (46.6%) compared to those in other country. Thus, the indications of H. pylori treatment should be strict to avoid artibiotics abuse which causes side effects and the increase of antibiotics resistant strains. The indications of H. pylori treatment are recommended for the patients with peptic ulcer disease, low grade gastric MALToma in Korea. The effect of the treatment after endoscopic mucosal resection of early gastric cancer is now controversial because of lack of reliable evidences. The first choice of H. pylori eradication regimen is a triple therapy composed of PPI (proton pump inhibitor) + amoxicillin + clarithromycin (or metronidazole) or RBC (ranitidine bismuth citrate) + amoxicillin + clarithromycin (or metronidazole). In case of failure of this regimen, quadruple therapy composed of PPI + bismuth+ tetracyclin + metronidazole is recommended. However, one week treatment with the regimen of PPI + amoxicillin + clarithromycin (or metronidazole) showed lower eradication rate (65.9%) in Korea than in Western countries because of the high frequency of metronidazole (40-80%) and clarithromycin (2-28.8%) resistant strains. Thus, further stuidies on treatment duration, drug doses, and antibiotics with less side effects is required. In conclusion, antibiotics for H. pylori eradication should be chosen considering the frequency of antibiotic resistant strains, patient's compliance, side effects, and administration method.