Korean J Helicobacter Up Gastrointest Res.  2015 Dec;15(4):211-221. 10.7704/kjhugr.2015.15.4.211.

Historical Perspective of Helicobacter pylori Treatment in Korea

Affiliations
  • 1Center for Gastric Cancer, National Cancer Center Hospital, Goyang, Korea. cij1224@ncc.re.kr
  • 2Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

Abstract

Since the discovery of Helicobacter pylori in 1983 by Warren and Marshall, it has been recognized as one of the most significant risk factors for gastric cancer and has been associated with various gastrointestinal disorders such as peptic ulcer disease. In Korea, the triple therapy of proton pump inhibitor, clarithromycin, and amoxicillin has been recommended as a primary regimen since 1998. However, the eradication rate of conventional first line therapy of H. pylori infection has been decreasing progressively, primarily due to increased resistance to antibiotics. A recent meta-analysis showed that the overall eradication rates were 74.6% by intention-to-treat analysis and 82.0% by per-protocol analysis. Therefore, the need for alternative first line eradication regimens has been rising. Sequential therapy, concomitant therapy, and various combinations of new antibiotics such as quinolone and rifabutin have been introduced as new options, but they have yet to be proven as standard first line therapy. Further nation-wide surveillance regarding the antibiotic resistance rates and well-designed prospective randomized controlled multicenter trials on the empirical first line therapy are necessary to establish the appropriate treatment for H. pylori in Korea.

Keyword

Anti-bacterial agents; Drug resistance; Helicobacter pylori; Therapy

MeSH Terms

Amoxicillin
Anti-Bacterial Agents
Clarithromycin
Drug Resistance
Drug Resistance, Microbial
Helicobacter pylori*
Helicobacter*
Korea*
Multicenter Studies as Topic
Peptic Ulcer
Prospective Studies
Proton Pumps
Rifabutin
Risk Factors
Stomach Neoplasms
Amoxicillin
Anti-Bacterial Agents
Clarithromycin
Proton Pumps
Rifabutin
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