Korean J Helicobacter Up Gastrointest Res.  2018 Dec;18(4):242-246. 10.7704/kjhugr.2018.18.4.242.

Optimal First-line Eradication Regimens for Helicobacter pylori Infection in Patients with Clarithromycin Resistance: A Pilot Study

Affiliations
  • 1Division of Gastroenterology, Department of Internal Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, Korea. kijoons@catholic.ac.kr

Abstract

BACKGROUND/AIMS
Helicobacter pylori eradication rates using first-line treatment have decreased due to clarithromycin resistance. The aim of this study was to investigate optimal eradication regimens for patients with clarithromycin resistance in Korea.
MATERIALS AND METHODS
A total of 72 patients with confirmed clarithromycin resistance were enrolled from August 2015 to July 2017. Patients were randomized to a 7-day bismuth quadruple therapy (BQT) regimen or a 7-day metronidazole triple therapy (MTT) regimen. Eradication was confirmed using the 13C-urea breath test.
RESULTS
There were no differences in baseline characteristics between the groups. Intention-to-treat eradication rates were 77.8% for the BQT group and 66.7% for the MTT group (P=0.293). Per protocol eradication rates were 87.5% for the BQT group and 77.4% for the MTT group (P=0.292). Adverse events were more frequent in the BQT group.
CONCLUSIONS
Eradication rates using MTT were comparable to those using BQT, and adverse events were less frequent in the MTT group. Thus, MTT may be considered as a first-line regimen for patients with clarithromycin resistance. Since this was a pilot study, a study with a large group is required.

Keyword

Clarithromycin; Helicobacter pylori; Metronidazole; Microbial drug resistance

MeSH Terms

Bismuth
Breath Tests
Clarithromycin*
Helicobacter pylori*
Helicobacter*
Humans
Korea
Metronidazole
Pilot Projects*
Bismuth
Clarithromycin
Metronidazole
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