Significance of Pretreatment

Original

대한Helicobacter 연구학회지 2002;2(1):30-35.
Published online June 21, 2002.

Helicobacter pylori 제균의 예측인자로서 치료 전 Δ¹³CO₂의 의의 -Omeprazole, amoxicillin, clarithromycin 7, 10, 14일 병합요법 치료효과와의 비교분석-

강창돈*·전훈재·이성준*·정록선·김경오·김용식·김영선·박철희·진윤태·이홍식·엄순호·이상우·최재현·김창덕·류호상·현진해

고려대학교 의과대학 내과학교실, 소화기 연구소, *강원대학교 의과대학 내과학교실

Abstract

Background/Aim: The efficacy of triple therapy with omeprazole, amoxicillin, and clarithromycin(OAC) for Helicobacter pylori(H. pylori) varies among different geographic regions and patient populations. We assessed the efficacy of the OAC regimen according to the treatment duration(7, 10 or 14 days) using ¹³C-urea breath test(¹³C-UBT) in Korea and the significance of pretreatment Δ¹³CO₂ as a predictor of success for H. pylori eradication. Methods: Total 387 patients with H. pylori infection(224 male and 163 female; mean age of 50.2 years, range of 18∼86) with peptic ulcer were randomly assigned to OAC (omeprazole 20 mg b.d., amoxycillin 1.0 g b.d. and clarithromycin 500 mg b.d.) 7, 10 or 14 days regimen. Eradication of H. pylori infection was assessed by ¹³C-UBT 4 weeks after completion of therapy. Results: No significant difference was in pretreatment Δ¹³CO₂ for the three groups(53.9⁑31.3‰, 41.5⁑27.8‰, 44.7⁑27.5‰). The overall eradication rate of H. pylori in each group was significantly higher in OAC 14 regimen than OAC 7 and 10 regimen(91.3% in OAC 14, 75.9% in OAC 7, and 80,2% in OAC 10, respectively, P＜0.05). Though the eradication rate of H. pylori decreased as the pretreatment Δ¹³CO₂ increased in all groups, the eradication rate of H. pylori in patients with higher bacterial densities(pretreatment Δ¹³CO₂＞60‰) in OAC 14 regimen was significantly higher than those in OAC 7 and 10 regimens(81.8% in OAC 14, 67.9% in OAC 7, and 62.5% in OAC 10, respectively, P＜0.05). Conclusions: The eradication rate of H. pylori was decreased as the pretreatment Δ¹³CO₂ increased. The rate of H. pylori eradication was the highest in OAC 14 regimen in our study. (Korean J Helicobacter Res Prac 2002;2:30-35)

Key Words: ¹³C-urea breath test, Duration of treatment, Pretreatment bacterial density