Recurrence Rate of <em>Helicobacter pylori </em>and Peptic Ulcer after Bismuth-containing Second-line Quadruple Therapy

Original

The Korean Journal of Helicobacter and Upper Gastrointestinal Research 2005;5(2):151-156.
Published online December 3, 2005.

Recurrence Rate of Helicobacter pylori and Peptic Ulcer after Bismuth-containing Second-line Quadruple Therapy

Bismuth 포함 사제요법을 통한 2차 제균 치료 후 Helicobacter pylori 및 소화성 궤양의 재발률

천재희·김나영*·김정목^† 김상균·김주성·이동호* 정현채·송인성

서울대학교 의과대학 내과학교실, 간연구소, 분당서울대학교병원 내과*, 한양대학교 의과대학 미생물학교실, 의과학연구소^†

Abstract

Background/Aims: To determine the recurrence rate of Helicobacter pylori infection and peptic ulcer after second-line eradication with bismuth-containing quadruple regimens. Methods: Sixty seven patients with peptic ulcer disease after successful eradication using second-line quadruple therapies were prospectively followed up at 6 months interval or when dyspepsia reappeared to ascertain H. pylori infection and ulcer status. Results: Three patients were lost during follow-up. The median follow-up duration was 26.8 months. H. pylori infection recurred in 11 of these 64 patients (17.2%), giving a calculated annual reinfection rate of 6.0%. Only one of the 11 patients was reinfected 12 months after the treatments. Four of 11 patients (36.4%) who became reinfected experienced peptic ulcer recurrence, but none of 53 patients who were not reinfected experienced recurrence. The reinfection rate did not depend on the age, sex, ulcer location, or eradication regimens. The relapse of dyspepsia was the only factor predictive of H. pylori recurrence. Conclusions: This study suggests that the recurrence rate of H. pylori at 1 year after second-line quadruple therapy is low, but the annual reinfection rate is as high as 6%. Surveillance for H. pylori reinfection facilitating peptic ulcer recurrence may be warranted even after a second-line eradication therapy, especially when dyspeptic symptoms reappear. (The Korean Journal of Helicobacter and Upper Gastrointestinal Research 2005;5:151-156)

Key Words: Helicobacter pylori, Reinfection, Recrudescence, Quadruple, Bismuth