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The Korean Journal of Helicobacter  and Upper Gastrointestinal Research 2010;10(1):1-5.
Published online July 10, 2010.
Current Status of Second-line and Third-line Therapy for Helicobacter pylori Eradication in Korea
헬리코박터 파일로리의 국내 2차, 3차 제균 요법 현황
안지용ㆍ정훈용
울산대학교 의과대학 소화기내과학교실, 서울아산병원 및 소화기병연구소
Abstract
Eradication of Helicobacter pylori (H. pylori) is needed in many cases. Seven or fourteen day triple therapy (proton pump inhibitor, amoxicillin, and clarithromycin) has been the main first-line therapy in Korea. However, the efficacy of this first-line therapy has become lower and the increase in antimicrobial resistance has happened, recently. When the first-line therapy is failed, seven or fourteen day quadruple regimen (proton pump inhibitor, bismuth salt, metronidazole, and tetracycline) is recommended as the standard second-line therapy in Korea. The eradication rate is 70.4∼96.3% in Korean patients, but the compliance is low. When the first and second-line therapy is failed, there is no standard treatment for H. pylori infection. In the situation of empirical third-line therapies, we can recommend some therapies including levofloxacin, moxifloxacin, and rifabutin. Triple regimen including levofloxacin showed 53.3∼74% eradication rate in Korea. This rate is relatively low, however, the compliance is higher than quadruple second-line regimen. Moxifloxacin-based therapy and rifabutin-based triple therapy have not been studied enough in Korea. Because of these insufficient data, it is difficult to choose proper treatment regimen when second-line therapy is failed. So, we need more well designed randomized controlled studies about third-line therapy. (The Korean Journal of Helicobacter and Upper Gastrointestinal Research 2010;10:1-5)
Key Words: Helicobacter pylori, Second-line therapy, Third-line therapy, Eradication rate


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