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The Korean Journal of Helicobacter  and Upper Gastrointestinal Research 2010;10(1):14-20.
Published online July 10, 2010.
Impact of Clarithromycin Resistance on the Outcome of Standard Triple Helicobacter pylori Eradication Therapy
Clarithromycin 내성이 Helicobacter pylori 표준 삼제 박멸요법에 미치는 영향
이정현ㆍ성인경ㆍ김정환ㆍ이선영ㆍ홍성노ㆍ박형석ㆍ심찬섭ㆍ진춘조 한혜승* 김균환
건국대학교 의학전문대학원 내과학교실, 병리학교실*, 약리학교실
Abstract
Background/Aims
Clarithromycin resistance in Helicobacter pylori is a major cause of the failure of eradication therapy. The object of this study was to determine the impact on impact of clarithromycin resistance on the outcome of standard triple Helicobacter pylori eradication therapy. Methods: From August 2005 to June 2009, The total of 798 patients with H. pylori infection and treated with standard H. pylori triple eradication therapy (proton pump inhibitor, amoxicillin, clarithromycin) were analyzed. The Pyrosequencing assay was carried out to detect H. pylori 23S rRNA mutations. Results: The eradication rates with standard triple therapy was 84.5% (673/798). The rates of 23S rRNA point mutation were 44.7% for the failed standard triple therapy group, which was higher than the 5.3% for the successfully eradicated control group (p=0.001). Conclusions: The clarithromycin resistance significantly affected the standard triple H. pylori eradication therapy. Therefore, the detection of clarithromycin resistance mutation in H. pylori by pyrosequencing before H. pylori eradication therapy may be helpful to select the best regimen to get successful H. pylori eradication. (The Korean Journal of Helicobacter and Upper Gastrointestinal Research 2010;10:14-20)
Key Words: Helicobacter pylori, Standard triple therapy, Clarithromycin resistance, 23S rRNA point mutation, Pyrosequencing assay


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