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Korean J Helicobacter  Up Gastrointest Res > Volume 18(2); 2018 > Article
The Korean Journal of Helicobacter  and Upper Gastrointestinal Research 2018;18(2):115-119.
DOI: https://doi.org/10.7704/kjhugr.2018.18.2.115    Published online June 10, 2018.
Standard First-line Triple Therapy for Helicobacter pylori Infection: A Comparison of Eradication Rates Based on Timing of Administration of Proton Pump Inhibitors
Seong Ju Lee, Yun Jeong Lim  , Seok Bo Hong, Ji Hyung Nam, Dong Kee Jang, Hyoun Woo Kang, Jae Hak Kim, Jun Kyu Lee, Moon Su Koh, Jin Ho Lee
Division of Gastroenterology, Department of Internal Medicine, Dongguk University Ilsan Hospital, Goyang, Korea. limyj@dongguk.ac.kr
Helicobacter pylori 일차 표준 삼제요법: 양성자펌프억제제 복용방법에 따른 제균성적 비교
이승주, 임윤정, 홍석보, 남지형, 장동기, 강현우, 김재학, 이준규, 고문수, 이진호
동국대학교일산병원 소화기내과
Correspondence:  Yun Jeong Lim, Tel: +82-31-961-7133, Fax: +82-31-961-9339, 
Email: limyj@dongguk.ac.kr
Received: 4 December 2017   • Revised: 31 January 2018   • Accepted: 1 February 2018
Recent Korean studies performed over the past few decades have shown diminishing efficacy and unacceptability of clarithromycin-based triple therapy as first-line eradication therapy for Helicobacter pylori infection, based on evidence of a declining eradication rate. Triple therapy continues to be used as first-line eradication therapy despite concerns regarding high clarithromycin resistance among Koreans. Patient compliance and acid suppression are important factors associated with the H. pylori eradication rate. We investigated whether regular administration of a proton pump inhibitor (PPI) 30 minutes before a meal can improve the eradication rate. MATERIALS AND METHODS: We retrospectively analyzed the data of 316 patients who were treated with first-line triple therapy (PPI, amoxicillin, and clarithromycin) for H. pylori infection between January 2012 and September 2017. Patients were divided into 2 groups based on the time of administration of the PPI (group A: before a meal, group B: after a meal). The urea breath test was performed 4~6 weeks after eradication of infection. RESULTS: Notably, 249 patients (78.8%, 249/316) showed successful eradication. The eradication rates in groups A and B were 87.5% (49/56 patients) and 76.9% (200/260 patients), respectively. We observed that regular administration of PPI before meals improved the eradication rate (P=0.079). CONCLUSIONS: We observed that although clarithromycin-based triple therapy was associated with an overall eradication rate <80%, regular PPI administration before meals improved the eradication rate. Regular PPI administration before meals and effective education to improve patient compliance could improve the eradication rate through maximal acid suppression.
Key Words: Eradication; Helicobacter pylori; Proton pump inhibitors; Triple therapy

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