Standard First-line Triple Therapy for Helicobacter pylori Infection: A Comparison of Eradication Rates Based on Timing of Administration of Proton Pump Inhibitors
Background/Aims: Recent Korean studies performed over the past few decades have shown diminishing efficacy and unacceptability of clarithromycin-based triple therapy as first-line eradication therapy for Helicobacter pylori infection, based on evidence of a declining eradication rate. Triple therapy...
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| Format: | Article |
| Language: | English |
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Korean College of Helicobacter and Upper Gastrointestinal Research
2018-06-01
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| Series: | The Korean Journal of Helicobacter and Upper Gastrointestinal Research |
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| Online Access: | http://www.helicojournal.org/journal/view.html?doi=10.7704/kjhugr.2018.18.2.115 |
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| author | Seong Ju Lee Yun Jeong Lim Seok Bo Hong Ji Hyung Nam Dong Kee Jang Hyoun Woo Kang Jae Hak Kim Jun Kyu Lee Moon-Su Koh Jin Ho Lee |
| author_facet | Seong Ju Lee Yun Jeong Lim Seok Bo Hong Ji Hyung Nam Dong Kee Jang Hyoun Woo Kang Jae Hak Kim Jun Kyu Lee Moon-Su Koh Jin Ho Lee |
| author_sort | Seong Ju Lee |
| collection | DOAJ |
| description | Background/Aims: Recent Korean studies performed over the past few decades have shown diminishing efficacy and unacceptability of clarithromycin-based triple therapy as first-line eradication therapy for Helicobacter pylori infection, based on evidence of a declining eradication rate. Triple therapy continues to be used as first-line eradication therapy despite concerns regarding high clarithromycin resistance among Koreans. Patient compliance and acid suppression are important factors associated with the H. pylori eradication rate. We investigated whether regular administration of a proton pump inhibitor (PPI) 30 minutes before a meal can improve the eradication rate. Materials and Methods: We retrospectively analyzed the data of 316 patients who were treated with first-line triple therapy (PPI, amoxicillin, and clarithromycin) for H. pylori infection between January 2012 and September 2017. Patients were divided into 2 groups based on the time of administration of the PPI (group A: before a meal, group B: after a meal). The urea breath test was performed 4∼6 weeks after eradication of infection. Results: Notably, 249 patients (78.8%, 249/316) showed successful eradication. The eradication rates in groups A and B were 87.5% (49/56 patients) and 76.9% (200/260 patients), respectively. We observed that regular administration of PPI before meals improved the eradication rate (P=0.079). Conclusions: We observed that although clarithromycin-based triple therapy was associated with an overall eradication rate ＜80%, regular PPI administration before meals improved the eradication rate. Regular PPI administration before meals and effective education to improve patient compliance could improve the eradication rate through maximal acid suppression. |
| format | Article |
| id | doaj-art-296a41908db141ffb7b85387213f1b6e |
| institution | Kabale University |
| issn | 1738-3331 |
| language | English |
| publishDate | 2018-06-01 |
| publisher | Korean College of Helicobacter and Upper Gastrointestinal Research |
| record_format | Article |
| series | The Korean Journal of Helicobacter and Upper Gastrointestinal Research |
| spelling | doaj-art-296a41908db141ffb7b85387213f1b6e2025-08-20T03:28:28ZengKorean College of Helicobacter and Upper Gastrointestinal ResearchThe Korean Journal of Helicobacter and Upper Gastrointestinal Research1738-33312018-06-0118211511910.7704/kjhugr.2018.18.2.115kjhugr.2018.18.2.115Standard First-line Triple Therapy for Helicobacter pylori Infection: A Comparison of Eradication Rates Based on Timing of Administration of Proton Pump InhibitorsSeong Ju Lee0Yun Jeong Lim1Seok Bo Hong2Ji Hyung Nam3Dong Kee Jang4Hyoun Woo Kang5Jae Hak Kim6Jun Kyu Lee7Moon-Su Koh8Jin Ho Lee9Division of Gastroenterology, Department of Internal Medicine, Dongguk University Ilsan Hospital, Goyang, KoreaDivision of Gastroenterology, Department of Internal Medicine, Dongguk University Ilsan Hospital, Goyang, KoreaDivision of Gastroenterology, Department of Internal Medicine, Dongguk University Ilsan Hospital, Goyang, KoreaDivision of Gastroenterology, Department of Internal Medicine, Dongguk University Ilsan Hospital, Goyang, KoreaDivision of Gastroenterology, Department of Internal Medicine, Dongguk University Ilsan Hospital, Goyang, KoreaDivision of Gastroenterology, Department of Internal Medicine, Dongguk University Ilsan Hospital, Goyang, KoreaDivision of Gastroenterology, Department of Internal Medicine, Dongguk University Ilsan Hospital, Goyang, KoreaDivision of Gastroenterology, Department of Internal Medicine, Dongguk University Ilsan Hospital, Goyang, KoreaDivision of Gastroenterology, Department of Internal Medicine, Dongguk University Ilsan Hospital, Goyang, KoreaDivision of Gastroenterology, Department of Internal Medicine, Dongguk University Ilsan Hospital, Goyang, KoreaBackground/Aims: Recent Korean studies performed over the past few decades have shown diminishing efficacy and unacceptability of clarithromycin-based triple therapy as first-line eradication therapy for Helicobacter pylori infection, based on evidence of a declining eradication rate. Triple therapy continues to be used as first-line eradication therapy despite concerns regarding high clarithromycin resistance among Koreans. Patient compliance and acid suppression are important factors associated with the H. pylori eradication rate. We investigated whether regular administration of a proton pump inhibitor (PPI) 30 minutes before a meal can improve the eradication rate. Materials and Methods: We retrospectively analyzed the data of 316 patients who were treated with first-line triple therapy (PPI, amoxicillin, and clarithromycin) for H. pylori infection between January 2012 and September 2017. Patients were divided into 2 groups based on the time of administration of the PPI (group A: before a meal, group B: after a meal). The urea breath test was performed 4∼6 weeks after eradication of infection. Results: Notably, 249 patients (78.8%, 249/316) showed successful eradication. The eradication rates in groups A and B were 87.5% (49/56 patients) and 76.9% (200/260 patients), respectively. We observed that regular administration of PPI before meals improved the eradication rate (P=0.079). Conclusions: We observed that although clarithromycin-based triple therapy was associated with an overall eradication rate ＜80%, regular PPI administration before meals improved the eradication rate. Regular PPI administration before meals and effective education to improve patient compliance could improve the eradication rate through maximal acid suppression.http://www.helicojournal.org/journal/view.html?doi=10.7704/kjhugr.2018.18.2.115EradicationHelicobacter pyloriProton pump inhibitorsTriple therapy |
| spellingShingle | Seong Ju Lee Yun Jeong Lim Seok Bo Hong Ji Hyung Nam Dong Kee Jang Hyoun Woo Kang Jae Hak Kim Jun Kyu Lee Moon-Su Koh Jin Ho Lee Standard First-line Triple Therapy for Helicobacter pylori Infection: A Comparison of Eradication Rates Based on Timing of Administration of Proton Pump Inhibitors The Korean Journal of Helicobacter and Upper Gastrointestinal Research Eradication Helicobacter pylori Proton pump inhibitors Triple therapy |
| title | Standard First-line Triple Therapy for Helicobacter pylori Infection: A Comparison of Eradication Rates Based on Timing of Administration of Proton Pump Inhibitors |
| title_full | Standard First-line Triple Therapy for Helicobacter pylori Infection: A Comparison of Eradication Rates Based on Timing of Administration of Proton Pump Inhibitors |
| title_fullStr | Standard First-line Triple Therapy for Helicobacter pylori Infection: A Comparison of Eradication Rates Based on Timing of Administration of Proton Pump Inhibitors |
| title_full_unstemmed | Standard First-line Triple Therapy for Helicobacter pylori Infection: A Comparison of Eradication Rates Based on Timing of Administration of Proton Pump Inhibitors |
| title_short | Standard First-line Triple Therapy for Helicobacter pylori Infection: A Comparison of Eradication Rates Based on Timing of Administration of Proton Pump Inhibitors |
| title_sort | standard first line triple therapy for helicobacter pylori infection a comparison of eradication rates based on timing of administration of proton pump inhibitors |
| topic | Eradication Helicobacter pylori Proton pump inhibitors Triple therapy |
| url | http://www.helicojournal.org/journal/view.html?doi=10.7704/kjhugr.2018.18.2.115 |
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