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헬리코박터 파일로리 감염의 일차 치료로써 7일 고용량 Esomeprazole 포함 표준 삼제 요법과 7일 표준 삼제 요법의 제균율 비교 연구

Efficacy of Seven-day High-dose Esomeprazole-based Triple Therapy versus Seven-day Standard Dose Non-esomeprazole-based Triple Therapy as the First-line Treatment of Patients with Helicobacter pylori Infection

대한소화기학회지 2020년 76권 3호 p.142 ~ 149
이영달, 김성은, 박선자, 박무인, 문원, 김재현, 정경원, 송지윤,
소속 상세정보
이영달 ( Lee Young-Dal ) - Kosin University College of Medicine Department of Internal Medicine
김성은 ( Kim Sung-Eun ) - Kosin University College of Medicine Department of Internal Medicine
박선자 ( Park Seun-Ja ) - Kosin University College of Medicine Department of Internal Medicine
박무인 ( Park Moo-In ) - Kosin University College of Medicine Department of Internal Medicine
문원 ( Moon Won ) - Kosin University College of Medicine Department of Internal Medicine
김재현 ( Kim Jae-Hyun ) - Kosin University College of Medicine Department of Internal Medicine
정경원 ( Jung Kyoung-Won ) - Kosin University College of Medicine Department of Internal Medicine
송지윤 ( Song Ji-Yun ) - Kosin University College of Medicine Department of Medicine

Abstract


Background/Aims: The rates of Helicobacter pylori (H. pylori) eradication have declined with the use of proton pump inhibitor- amoxicillin-clarithromycin as the first-line triple therapy. On the other hand, several studies have suggested that high gastric pH levels could affect the H. pylori eradication rate by enhancing the efficacy of antimicrobials. This study compared the efficacy of seven-day high-dose esomeprazole-based triple therapy (7-HEAC) for first-line H. pylori eradication with the seven-day standard dose non-esomeprazole-based triple therapy (7-NEAC) to identify the risk factors related to eradication failure.

Methods: This study included 223 patients who were diagnosed with a H. pylori infection and received 7-HEAC or 7-NEAC between June 2016 and January 2017. The H. pylori eradication rates, as well as demographic and clinical factors, were investigated retrospectively. H. pylori eradication was confirmed by a 13C-urea breath test or rapid urease test at least 4 weeks after the completion of therapy.

Results: The eradication rates were 67.7% (105/155; 95% CI 59.5-74.8%) in the 7-NEAC group and 80.9% (55/68; 95% CI 69.9-89.8%) in the 7-HEAC group (p=0.045). The adverse event rates were 5.8% (9/155) in the 7-NEAC group and 7.4% (5/68) in the 7-HEAC group (p=0.661). Multivariate analysis revealed being female (OR 2.08; 95% CI 1.15-3.76) to be associated with the failure of H. pylori eradication therapy.

Conclusions: The eradication rate of the 7-HEAC group was higher than that of the 7-NEAC group. Nevertheless, more effective first-line therapies may be necessary for H. pylori eradication in the near future.

키워드

Helicobacter pylori; Disease eradication; Esomeprazole; Proton pump inhibitors

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