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대한Helicobacter 연구학회지 2003;3(1):19-24.
Published online June 30, 2003.
Cure of Helicobacter pylori Infection: Comparison of Standard versus Low Doses of Clarithromycin in Combination with Amoxicillin and Pantoprazole
Helicobacter pylori 양성인 소화성 궤양 및 만성 위염 환자에서 표준용량과 저용량의 Clarithromycin 3제요법의 제균효과 비교
김남훈ㆍ정용희·한요셉ㆍ김효종·김병호·장영운ㆍ이정일ㆍ장 린
경희대학교 의과대학 소화기내과학교실
Abstract
Background/Aims: Proton pump inhibitor-based triple therapies are recommended as the first-line treatment for Helicobacter pylori(H. pylori) eradication. However, the effect of lowering clarithromycin dose is still controversial. The aim of this study was to evaluate the efficacy of low-dose clarithromycin triple therapy. Methods: Ninety patients with gastric ulcer(n=27), duodenal ulcer(n= 36), combined gastric and duodenal ulcer(n=7), or chronic gastritis(n=20) were randomly assigned to two groups. Patients were treated either with pantoprazole 40 mg b.d, amoxicillin 750 mg b.d, and clarithromycin 250 mg b.d(PAC 250 n=45) or with pantoprazole 40 mg b.d, amoxicillin 1 g b.d, and clarithromycin 500 mg b.d(PAC 500 n=45) for 7 days. H. pylori infection was assessed by rapid urease test at the beginning of the study. Eradication was determined by 13C-urea breath test at the 4-6 weeks after treatment. Also, adverse events were asked at the 4 weeks after treatment. Results: H. pylori eradication rates in PAC 250 and PAC 500 were 75.5% and 73.3% by intention-to-treat analysis and 91.9% and 91.7% by per-protocol analysis, respectively. Seven patients in PAC 250(15.6%) and 10 in PAC 500(22.2%) complained adverse events which were usually mild(P=N.S.). Conclusions: Low dose clarithromycin triple therapy was as effective as standard triple therapy in eradication of H. pylori infection while its side effects were less frequent. (Korean J Helicobacter Res Prac 2003;3:19-24)
Key Words: Helicobacter pylori, clarithromycin, Triple therapy
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