Status of <i>Helicobacter pylori</i> Eradication in Japan

Kim, Gwang Ha

doi:2017.17.1.4

Korean J Helicobacter Up Gastrointest Res > Volume 17(1); 2017 > Article

Review

The Korean Journal of Helicobacter and Upper Gastrointestinal Research 2017;17(1):4-10.
DOI: https://doi.org/10.7704/kjhugr.2017.17.1.4 Published online March 10, 2017.

Status of Helicobacter pylori Eradication in Japan

Gwang Ha Kim

¹Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea. doc0224@pusan.ac.kr
²Biomedical Research Institute, Pusan National University Hospital, Busan, Korea.

일본에서 헬리코박터 제균 치료

김광하^1,2

부산대학교 의학전문대학원 내과학교실¹, 부산대학교병원 의생명연구원²

Correspondence: Gwang Ha Kim,
Email: doc0224@pusan.ac.kr

Received: 21 December 2016 • Revised: 30 December 2016 • Accepted: 30 December 2016

Abstract

Like Korea, Japan is one of the countries with the highest incidence of gastric cancer and Helicobacter pylori infection. However, the guidelines on H. pylori eradication differ between Japan and Korea. Since 2013, the indications for H. pylori eradication in Japan include all H. pylori-associated gastritis for prevention of gastric cancer and H. pylori dissemination. For first-line therapy, a standard triple therapy comprising of amoxicillin, clarithromycin, and a proton pump inhibitor is used for 1 week. However, the eradication rate has recently decreased owing to the increasing resistance of H. pylori to clarithromycin. For second-line therapy, a combination of amoxicillin, metronidazole, and a proton pump inhibitor is used for 1 week, but the eradication rate is still unacceptable (≒90%). The main distinguishing aspects of eradication therapy in Japan are the low dose of antibiotics (especially clarithromycin), the short duration (7 days), the low resistance rate of H. pylori to metronidazole, the absence of a bismuth-based regimen, and the recent approval of potassium ion-competitive acid blocker for eradication therapy.

Key Words: Helicobacter pylori; Therapy; Drug resistance; Japan