Efficacy of Proton Pump Inhibitor-based Triple Therapy and Bismuth-based Quadruple Therapy for Helicobacter pylori Eradication in Korean Children
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Purpose: The aim of this study was to assess and compare the efficacies of proton pump inhibitor-based triple therapy and bismuth-based quadruple therapy as first-line treatments for Helicobacter pylori eradication in Korean children. Methods: We retrospectively reviewed the data of children who had been diagnosed with H. pylori infection at the Seoul National University Bundang Hospital from March 2004 to August 2012. The patients were randomly assigned to receive either triple therapy consisting of omeprazole, amoxicillin, and clarithromycin for 2 weeks (OAC group) or quadruple therapy comprising omeprazole, amoxicillin, metronidazole, and bismuth salts for 1 week (OAMB group). The patients were evaluated for eradication of H. pylori infection at 4 weeks after the completion of the treatment. Results: Of the 129 children enrolled in this study, 118 (91.5%) were included in the final analysis. The eradication rates in OAC and OAMB groups were 67.7% (42/62) and 83.9% (47/56), respectively, which were significantly different between the 2 treatment groups (p=0.041). The eradication rates in the OAMB group during the periods 2004-2006, 2007-2009, and 2010-2012 were superior to those in the OAC group. Conclusion: This study indicated that the 1-week bismuth-based quadruple therapy, compared with the standard 2-week triple therapy, was significantly more successful in eradicating H. pylori infection in Korean children.
Abstract
Purpose: The aim of this study was to assess and compare the efficacies of proton pump inhibitor-based triple therapy and bismuth-based quadruple therapy as first-line treatments for Helicobacter pylori eradication in Korean children. Methods: We retrospectively reviewed the data of children who had been diagnosed with H. pylori infection at the Seoul National University Bundang Hospital from March 2004 to August 2012. The patients were randomly assigned to receive either triple therapy consisting of omeprazole, amoxicillin, and clarithromycin for 2 weeks (OAC group) or quadruple therapy comprising omeprazole, amoxicillin, metronidazole, and bismuth salts for 1 week (OAMB group). The patients were evaluated for eradication of H. pylori infection at 4 weeks after the completion of the treatment. Results: Of the 129 children enrolled in this study, 118 (91.5%) were included in the final analysis. The eradication rates in OAC and OAMB groups were 67.7% (42/62) and 83.9% (47/56), respectively, which were significantly different between the 2 treatment groups (p=0.041). The eradication rates in the OAMB group during the periods 2004-2006, 2007-2009, and 2010-2012 were superior to those in the OAC group. Conclusion: This study indicated that the 1-week bismuth-based quadruple therapy, compared with the standard 2-week triple therapy, was significantly more successful in eradicating H. pylori infection in Korean children.
참고문헌 (25)
- Suerbaum S, "Helicobacter pylori infection", N Engl J Med, 347, pp.1175~1186 (2002)
- Malfertheiner P, "Management of Helicobacter pylori infection--the Maastricht IV", Florence Consensus Report, 2012, pp.61, 646~664
- Gold BD, "Helicobacter pylori infection in children: recommendations for diagnosis and treatment", J Pediatr Gastroenterol Nutr, 31, pp.490~497 (2000)
- 김승영, "국내 Helicobacter pylori 의 제균 치료", 대한소화기학회지, 58(2), pp.67~73 (2011), 대한소화기학회
- Zullo A, "Standard triple and sequential therapies for Helicobacter pylori eradication: An update", Eur J Intern Med (2012)
- Graham DY, "Helicobacter pylori treatment in the era of increasing antibiotic resistance", Gut, 59, pp.1143~1153 (2010)
- Kalach N, "Clarithromycin resistance and eradication of Helicobacter pylori in children", Antimicrob Agents Chemother, 45, pp.2134~2135 (2001)
- Yang HR, "Diagnostic accuracy of the C-urea breath test in children: adjustment of the cut-off value according to age", J Gastroenterol Hepatol, 20, pp.264~269 (2005)
- Koletzko S, "Evidence-based guidelines from ESPGHAN and NASPGHAN for Helicobacter pylori infection in children", J Pediatr Gastroenterol Nutr, 53, pp.230~243 (2011)
- 최인경, "소아에서 Omeprazole, Amoxicillin, Clarithromycin 삼제 병합 요법의 치료기간별 Helicobacter pylori 제균율", Pediatric Gastroenterology, Hepatology & Nutrition, 5(1), pp.19~25 (2002), 대한소아소화기영양학회
- Jungi Choi, "Efficacy of Two Triple Eradication Regimens in Children with Helicobacter pylori Infection", Journal of Korean Medical Science, 21(6), pp.1037~1040 (2006), 대한의학회
- Oderda G, "Results from the pediatric European register for treatment of Helicobacter pylori (PERTH)", Helicobacter, 12, pp.150~156 (2007)
- Koletzko S, "Prospective multicentre study on antibiotic resistance of Helicobacter pylori strains obtained from children living in Europe", Gut, 55, pp.1711~1716 (2006)
- Hwang TJ, "Change in antibiotic resistance of Helicobacter pylori strains and the effect of A2143G point mutation of 23S rRNA on the eradication of H. pylori in a single center of Korea", J Clin Gastroenterol, 44, pp.536~543 (2010)
- 김유미, "한국인 소아에서 분리한 Helicobacter pylori 균주의 항균제 내성률", Pediatric Gastroenterology, Hepatology & Nutrition, 14(1), pp.45~51 (2011), 대한소아소화기영양학회
- Ford AC, "Adverse events with bismuth salts for Helicobacter pylori eradication: systematic review and meta-analysis", World J Gastroenterol, 14, pp.7361~7370 (2008)
- Ertem D, "Clinical practice: Helicobacter pylori infection in childhood", Eur J Pediatr (2012)
- 김정목, "한국인 환자에서 분리한 Helicobacter pylori 균주의 항생제 내성률", 대한소화기학회지, 47(5), pp.337~349 (2006), 대한소화기학회
- Laine L, "Bismuth-based quadruple therapy using a single capsule of bismuth biskalcitrate, metronidazole, and tetracycline given with omeprazole versus omeprazole, amoxicillin, and clarithromycin for eradication of Helicobacter pylori in duodenal ulcer patients: a prospective, randomized, multicenter, North American trial", Am J Gastroenterol, 98, pp.562~567 (2003)
- Katelaris PH, "A randomized comparison of quadruple and triple therapies for Helicobacter pylori eradication: The QUADRATE Study", Gastroenterology, 123, pp.1763~1769 (2002)
- 김나영, "헬리코박터 파일로리 감염의 진단 및 치료 가이드라인", 대한소화기학회지, 54(5), pp.269~278 (2009), 대한소화기학회
- 장현주, "Helicobacter pylori 감염 1차 치료를 위한 삼제요법과 사제요법의 제균 효과", 대한소화기학회지, 46(5), pp.368~372 (2005), 대한소화기학회
- 조현진, "Helicobacter pylori 1차 치료시 삼제요법과 Bismuth 포함 사제요법에서의 제균율 비교", Clinical Endoscopy, 37(4), pp.259~264 (2008), 대한소화기내시경학회
- Bahremand S, "Evaluation of triple and quadruple Helicobacter pylori eradication therapies in Iranian children: a randomized clinical trial", Eur J Gastroenterol Hepatol, 18, pp.511~514 (2006)
- Dehghani SM, "Efficacy of the standard quadruple therapy versus triple therapies containing proton pump inhibitor plus amoxicillin and clarithromycin or amoxicillin-clavulanic acid and metronidazole for Helicobacter pylori eradication in children", Dig Dis Sci, 54, pp.1720~1724 (2009)