Current Status of Second-line and Third-line Therapy for Helicobacter pylori Eradication in Korea
Korean J Helicobacter Up Gastrointest Res 2010;10(1):1-5
Published online July 10, 2010
© 2010 Korean College of Helicobacter and Upper Gastrointestinal Research.

Ji Yong Ahn, M.D. and Hwoon-Yong Jung, M.D., PhD.

Department of Gastroenterology, University of Ulsan College of Medicine, Asan Medical Center, Asan Digestive Disease Research Institute, Seoul, Korea
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Eradication of Helicobacter pylori (H. pylori) is needed in many cases. Seven or fourteen day triple therapy (proton pump inhibitor, amoxicillin, and clarithromycin) has been the main first-line therapy in Korea. However, the efficacy of this first-line therapy has become lower and the increase in antimicrobial resistance has happened, recently. When the first-line therapy is failed, seven or fourteen day quadruple regimen (proton pump inhibitor, bismuth salt, metronidazole, and tetracycline) is recommended as the standard second-line therapy in Korea. The eradication rate is 70.4∼96.3% in Korean patients, but the compliance is low. When the first and second-line therapy is failed, there is no standard treatment for H. pylori infection. In the situation of empirical third-line therapies, we can recommend some therapies including levofloxacin, moxifloxacin, and rifabutin. Triple regimen including levofloxacin showed 53.3∼74% eradication rate in Korea. This rate is relatively low, however, the compliance is higher than quadruple second-line regimen. Moxifloxacin-based therapy and rifabutin-based triple therapy have not been studied enough in Korea. Because of these insufficient data, it is difficult to choose proper treatment regimen when second-line therapy is failed. So, we need more well designed randomized controlled studies about third-line therapy. (The Korean Journal of Helicobacter and Upper Gastrointestinal Research 2010;10:1-5)
Keywords : Helicobacter pylori, Second-line therapy, Third-line therapy, Eradication rate

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