| Rescue therapies for Helicobacter pylori infection after failure of proton pump inhibitor-based standard triple therapy |
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Young Hwan Seo, Su Yeon Rhie, Bum Joon Park, Hyung Joon Kim, Jae Gyu Kim |
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전남대학교병원 심장센터, 간호부, 전남대학교 심혈관계 특성화 사업단 |
| 원저 : 프로톤펌프억제제 포함 표준요법 실패 후 Helicobacter pylori 감염 구제요법 |
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서영환 . 이수연 . 박범준 . 김형준 . 김재규, Su Yeon Rhie, Bum Joon Park, Hyung Joon Kim, Jae Gyu Kim |
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| Abstract |
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Background/Aims : Proton pump inhibitor (PPI)-based standard triple therapy for Helicobacter pylori infection is widely used, but it has a considerable failure rate. The aim of this study was to evaluate the efficacy and tolerability of rescue therapies with a quadruple regimen and a rifabutin-based regimen for patients who experienced failure with PPI-based standard triple therapy.
Methods : From July 2004 through October 2006, 52 patients for whom first‐line triple therapy (PPI, amoxicillin and clarithromycin) had failed were included in this study. They were treated with a quadruple regimen for 7 days (PPI, bismuth, tetracycline and metronidazole) as a second‐line therapy. For third‐line therapy, a rifabutin-based regimen (PPI, rifabutin and amoxicillin) was prescribed for 14 days. The H. pylori status was determined before and at least 4 weeks after therapy by the 13C urea breath test or by endoscopy with antral and corpus biopsies for a rapid urease test, histological examination and culture.
Results : The mean age was 52.6 years. Thirteen patients (25%) of the 52 patients were dropped. The eradication rate of the quadruple therapy was 84.6% (33/39). Three patients of the 6 failures with quadruple therapy were then treated with the rifabutin-based regimen. The eradication rate of the rifabutin-based therapy was 100% (3/3). Adverse effects (10.2%) were reported in 4 patients who were treated with quadruple regimen.
Conclusions : The quadruple regimen is still an effective second-line therapy for Korean patients who experience failure with PPI-based standard triple therapy. The rifabutin-based regimen could be used as a third-line rescue therapy in Korea. (Korean J Med 74:23-29, 2008)
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| Key Words:
Helicobacter pylori; Second line therapy; Rescue therapy |
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