The Trends of One-week First-line and Second-line Eradication Therapy for Helicobacter pylori Infection in Korea

Background/Aims: Increasing levels of bacterial antibiotic resistance raise the need to assess the eradication efficiency of Helicobacter pylori. The aim of this study was to evaluate 7-year changes in efficacy of one-week first line and second line therapies in Helicobacter pylori eradication rates in Korea. Methodology: From 2001 to 2007, 4,198 Helicobacter pylori-positive patients received first-line therapy (proton pump inhibitor, amoxicillin 1,000 mg b.i.d., and clarithromycin 500 mg b.i.d.). Four hundred ninety patients received second-line therapy (proton pump inhibitor twelve hourly, metronidazole 500 mg t.i.d., tetracycline 500 mg q.i.d., and bismuth 300 mg q.i.d.). A C-13-urea breath test was used to determine the eradication rate. Results: The eradication rates of first-line therapy were 81.3%, 83.7%, 80.1%, 80.7%, 82.0%, 75.9%, and 77.5% from 2001 to 2007, with a decreasing trend (p < 0.01). The eradication rate of second-line therapy was 77.3%, 86.2%, 95.6%, 95.9%, 89.6%, 83.2%, and 86.4% from 2001 to 2007 without decreasing trend (p=0.26). Conclusions: The eradication rate of first-line therapy has decreased in the last 7 years while that of second-line therapy has remained the same. A new strategy is required to improve the first-line therapy for Helicobacter pylori eradication in Korea.