Korean J Gastroenterol.  2018 Nov;72(5):237-244. 10.4166/kjg.2018.72.5.237.

New Helicobacter pylori Eradication Therapies

Affiliations
  • 1Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Korea. jgkimd@cau.ac.kr

Abstract

While the prevalence of Helicobacter pylori (H. pylori) infection is decreasing in Korea, the incidence of gastric cancer remains high, emphasizing the importance of H. pylori eradication. A new treatment strategy is needed as the eradication rate with standard triple therapy, which is currently the standard first-line regimen for H. pylori infection, has decreased below the optimum level. The major cause of eradication failure is increased antibiotic resistance. Sequential, concurrent, and hybrid therapies that include clarithromycin produce higher eradication rates than conventional standard triple therapy. However, the effectiveness of these treatments is limited in regions where the resistance rate to various antibiotics is high. Bismuth quadruple therapy is another alternative therapy, but again the eradication rate is not sufficiently high. Tailored therapy based on individual characteristics, including antibiotic susceptibility, may be ideal, but there are several limitations for clinical application and further research is needed. New potassium-competitive acid blocker-based therapies could emerge as effective alternatives in the near future. A consensus is needed to establish a strategy for applying new eradication therapies in Korea.

Keyword

Helicobacter pylori; Therapeutics; Guideline; Korea

MeSH Terms

Anti-Bacterial Agents
Bismuth
Clarithromycin
Consensus
Drug Resistance, Microbial
Helicobacter pylori*
Helicobacter*
Incidence
Korea
Prevalence
Stomach Neoplasms
Anti-Bacterial Agents
Bismuth
Clarithromycin

Figure

  • Fig. 1 A treatment scheme for Helicobacter pylori infection. STT, standard triple therapy; BQT, bismuth-containing quadruple therapy. aDue to paucity of data regarding the efficacy of BQT as a first-line therapy or rescue therapy after sequential/concomitant therapy, there might be controversy in choosing this regimen.


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