Historical Perspective of <i>Helicobacter pylori</i> Treatment in Korea

Lee, Jong Yeul; Ahn, Ji Yong; Choi, Il Ju

doi:2015.15.4.211

Korean J Helicobacter Up Gastrointest Res > Volume 15(4); 2015 > Article

Review

The Korean Journal of Helicobacter and Upper Gastrointestinal Research 2015;15(4):211-221.
DOI: https://doi.org/10.7704/kjhugr.2015.15.4.211 Published online December 10, 2015.

Historical Perspective of Helicobacter pylori Treatment in Korea

Jong Yeul Lee, Ji Yong Ahn, Il Ju Choi

¹Center for Gastric Cancer, National Cancer Center Hospital, Goyang, Korea. cij1224@ncc.re.kr
²Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

우리나라에서 Helicobacter pylori 제균치료의 역사적 고찰

이종열, 안지용¹, 최일주

국립암센터 부속병원 위암센터, 울산대학교 의과대학 서울아산병원 소화기내과학교실¹

Abstract

Since the discovery of Helicobacter pylori in 1983 by Warren and Marshall, it has been recognized as one of the most significant risk factors for gastric cancer and has been associated with various gastrointestinal disorders such as peptic ulcer disease. In Korea, the triple therapy of proton pump inhibitor, clarithromycin, and amoxicillin has been recommended as a primary regimen since 1998. However, the eradication rate of conventional first line therapy of H. pylori infection has been decreasing progressively, primarily due to increased resistance to antibiotics. A recent meta-analysis showed that the overall eradication rates were 74.6% by intention-to-treat analysis and 82.0% by per-protocol analysis. Therefore, the need for alternative first line eradication regimens has been rising. Sequential therapy, concomitant therapy, and various combinations of new antibiotics such as quinolone and rifabutin have been introduced as new options, but they have yet to be proven as standard first line therapy. Further nation-wide surveillance regarding the antibiotic resistance rates and well-designed prospective randomized controlled multicenter trials on the empirical first line therapy are necessary to establish the appropriate treatment for H. pylori in Korea.

Key Words: Anti-bacterial agents; Drug resistance; Helicobacter pylori; Therapy