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Korean J Helicobacter  Up Gastrointest Res > Volume 18(4); 2018 > Article
The Korean Journal of Helicobacter  and Upper Gastrointestinal Research 2018;18(4):242-246.
DOI: https://doi.org/10.7704/kjhugr.2018.18.4.242    Published online December 10, 2018.
Optimal First-line Eradication Regimens for Helicobacter pylori Infection in Patients with Clarithromycin Resistance: A Pilot Study
Min Woo Seo  , Yeon Jeong Jeong  , Joon Sung Kim  , Byung Wook Kim 
Division of Gastroenterology, Department of Internal Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, Korea. kijoons@catholic.ac.kr
국내 클래리스로마이신 내성균에서 가장 효과적인 헬리코박터 제균치료법
서민우, 정연정, 김준성, 김병욱
가톨릭대학교 의과대학 내과학교실 인천성모병원 소화기내과
Correspondence:  Joon Sung Kim, Tel: +82-32-280-5051, Fax: +82-32-280-5082, 
Email: kijoons@catholic.ac.kr
Received: 22 August 2018   • Revised: 30 September 2018   • Accepted: 3 October 2018
Abstract
BACKGROUND/AIMS
Helicobacter pylori eradication rates using first-line treatment have decreased due to clarithromycin resistance. The aim of this study was to investigate optimal eradication regimens for patients with clarithromycin resistance in Korea. MATERIALS AND METHODS: A total of 72 patients with confirmed clarithromycin resistance were enrolled from August 2015 to July 2017. Patients were randomized to a 7-day bismuth quadruple therapy (BQT) regimen or a 7-day metronidazole triple therapy (MTT) regimen. Eradication was confirmed using the 13C-urea breath test. RESULTS: There were no differences in baseline characteristics between the groups. Intention-to-treat eradication rates were 77.8% for the BQT group and 66.7% for the MTT group (P=0.293). Per protocol eradication rates were 87.5% for the BQT group and 77.4% for the MTT group (P=0.292). Adverse events were more frequent in the BQT group. CONCLUSIONS: Eradication rates using MTT were comparable to those using BQT, and adverse events were less frequent in the MTT group. Thus, MTT may be considered as a first-line regimen for patients with clarithromycin resistance. Since this was a pilot study, a study with a large group is required.
Key Words: Clarithromycin; Helicobacter pylori; Metronidazole; Microbial drug resistance


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