Recent Six-Year Experiences of PPI-Based Triple Therapy of Heliobacter pylori

Abstract

Purpose: The success rate of Proton pump inhibitor (PPI) based triple therapy for Heliobacter pylori eradication has been decreased recently. The aim of this study was to evaluate the recent 6-year experience of the eradication and the reinfection rates after the successful eradication of H. pylori infection in a single center of Korea. Methods: From March 2002 to April 2008, 584 patients with H. pylori-positive peptic ulcer disease and gastritis received the PPI-based triple therapy for 7 days (PPI, amoxicillin 1 g, clarithromycin 500 mg all twice daily). 13C-urea breath test was assessed to determine the H. pylori status after the eradication. The 83 patients with mean 1.2-years follow-up after the successful eradication were included. The eradication rate and the effect of age, gender, activity and the location of ulcer and the types of PPI were examined. Results: The overall H. pylori eradication rate was 83.7%. Annual success rate of H. pylori eradication from year 2003 to 2007 tended not to be decreased (95.7, 86.6, 80.7, 83.5, and 86%, respectively). The eradication rate was not different according to types of PPI (lansoprazole vs. omeprazole vs. rabeprazole; 82.6, 86.2, 84.7%, respectively). There were also no significant difference in eradication rate according to gender, age, the activity and location of the ulcer. The cumulative reinfection rate and the recurrence rate of peptic ulcer was 6.0% and 18.3% during mean 1.2 year follow up period. However, the recurrence of the disease was not associated with the status of H. pylori infection. Conclusion: PPI-based triple therapy seems to be still effective for the first-line therapy of H. pylori eradication. However a new treatment regime should be developed to overcome the lower eradication rate.