Treatment of <I>H. pylori</I> Infection in Primary Care Center

대한Helicobacter 연구학회지 2001;1(1):63-67.
Published online December 30, 2001.

Treatment of H. pylori Infection in Primary Care Center

1차 의료기관에서의 Helicobacter pylori 감염의 치료

이동호

보라매병원 내과

Abstract

The prevalance of H. pylori infection in general population of Korea in high(60∼80%). However the strict indications of H. pylori treatment in primary care center are needed because of increase of antibiotics resistant strain and side effect of drugs, due to artibiotics abuse. The treatment indications of H. pylori infecticn in Korea are peptic ulcer disease(gasitic ulcer and duodenal ulcer), low grade gastric MALToma, following endoscopic mucosal resection(EMR) of EGC. But the management of gartric MALToma in primary care center is not easy in practice. The staging work-up and follow-up studies of gartic MALToma are very important and these studies are not available in prmary care center. So the treatment of gartric MALToma in prmary care center is not recommeded. The treatment of H. pylori infection in following EMR of EGC case is now somewhat debating because of lack of large prospective study. The first choice of H. pylori eradication regimen is PPI+amoxicillin+clarithromycin(or metronidazole) and RBC+amoxicillin+clarithromycin(or metronidazole). In case of failure of first choice regimen in H. pylori eiadication, PPI+bismuth+tetracycllin+metronidazole is recommended. But, in Korea the frequency of metronidazole resistant strain is 40∼50% and the frequency of clarithromycin resistant strain is 2∼13%. Therefore, in the future the choice of antibiotics should be adjusted to the frequency of antibiotics resistant strains and the situations of new emerging antibiotics resistant strain. And the patient's compliance, the cost-effectiveness, and the side effects of drugs should be considered in the choice of H. pylori eradication regimen. Now the H. pylori eradication for the prevention of gartric cancer is not recommended in Korea. Despite considerable advances, further research studies are needed to provide definite direction for the treatment of many conditions in primary care center in Korea. (Korean J Helicobacter Res Prac 2001;1:63-67)

Key Words: Eradication regimen, Helicobacter pylori infection, Korea, Peptic ulcer, Primary care center