Korean J Gastroenterol.
2003 Sep;42(3):195-203.
Retreatment of Helicobacter pylori Infection with Triple Therapy after Initial Treatment Failure
- Affiliations
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- 1Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea. nayoungkim49@yahoo.co.kr
- 2Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
- 3Department of Internal Medicine, Kangnam General Hospital, Public Corporation, Seoul, Korea.
- 4Department of Clinical Pathology, Kangnam General Hospital, Public Corporation, Seoul, Korea.
- 5Department of Microbiology and Institute of Biomedical Science, Hanyang University College of Medicine, Seoul, Korea.
Abstract
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BACKGROUND/AIMS: Helicobacter pylori (H. pylori) treatments fail at least in 10-20% of patients. However, retreatment strategies after failure of initial treatment have not been established. This study was conducted to evaluate the eradication rate of retreatment choices.
METHODS
Twenty-seven peptic ulcer patients who were retreated with OAC (omeprazole + amoxicillin + clarithromycin) or BMT (bismuth + metronidazole + tetracycline) after failure of BMT or OAC were included. Quadruple therapy (omeprazole + BMT) was also tried after failure of two successive triple therapies. Furthermore, the effect of resistance of metronidazole or clarithromycin on the eradication of H. pylori was evaluated.
RESULTS
Among 13 patients who were retreated with OAC after failure of BMT regimen, H. pylori was eradicated in 10 patients (76.9%). Among 14 patients retreated with BMT after failure of OAC regimen, H. pylori was eradicated in 11 patients (78.6%). Resistance of H. pylori to metronidazole or clarithromycin decreased the efficacy of BMT or OAC, respectively.
CONCLUSIONS
Eradication regimen should be decided considering the resistance to H. pylori. However, in case of unknown state of resistance, OAC can be chosen if BMT fails. Similarly, BMT can be tried in cases that OAC therapy failed. After failures of both triple therapies, quadruple therapy can be tried as the next step.
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