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The Korean Journal of Helicobacter  and Upper Gastrointestinal Research 2004;4(1):1-6.
Published online June 30, 2004.
Treatment for Helicobacter pylori Infection according to Antimicrobial Resistance
항생제 내성에 따른 Helicobacter pylori 감염의 치료
김재규·박실무
중앙대학교 의과대학 내과학교실
Abstract
Significant progress and new insights have been gained since Helicobacter pylori was found in 1982. Even with currently most effective treatment regimen, about 10∼20% of patients will fail to obtain eradication of H. pylori. Triple therapy (proton pump inhibitor(PPI), amoxicillin and clarithromycin) has been the main first line treatment for H. pylori infection in Korea. However, the effectiveness of triple therapy is decreasing due to the increase in antimicrobial resistance. This review will focus on the empirical treatment for H. pylori infection. In the case of failure of triple therapy, quadruple therapy(PPI, a bismuth salt, metronidazole and tetracycline) is a very effective second-line regimen. After the failure of two or more eradication treatments, resistance to antibiotics should be evaluated and the regimen of third-line treatment should be selected according to antimicrobial susceptibility. The empirical third-line treatments, recommended in the cases that antimicrobial susceptibility test is unavailable, are triple therapies including rifabutin, moxifloxacin, or levofloxacin or dual therapy including high dose PPI and amoxicillin. Multiple eradication failures should be handled on a case-by-case basis by specialist. (Korean J Helicobacter Upper Gastrointest Res 2004;4:1-6)
Key Words: Helicobacter pylori, Antimicrobial resistance, Treatment


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