Abstract
BACKGROUND/AIM: The eradication rates attained by the PPI-based triple therapy were first reported to be around 85~91%. Not only bacterial resistance to anti-microbial agents but also insufficient acid inhibition during the eradication treatment causes eradication failure. Thus, there has recently been much debate on whether the currently used standard seven days triple therapy is sufficient for Helicobacter pylori eradication. The authors undertook the study to find out whether the currently implemented seven day treatment is pertinent. Methods: From January 2006 through October 2008, eight hundred fifty nine patients with Helicobacter pylori positive peptic ulcer disease or chronic gastritis who received first line therapy with esomeprazol 20mg, amoxicillin 1000mg and clarithromycin 500mg bid for 7 days were prospectively evaluated. Successful eradication therapy was defined as a negative 13C-urea breath test 6 to 8 weeks after the completion of the treatment. Result: There were 565 male and 294 female. Mean age was 56.3 years. Of all the subjects, 77.4% (665/859) showed negative 13C-urea breath test results. There were no difference in the eradication rate of Helicobacter pylori between people living in urban and rural areas (78.4% vs 76.4%). There were no differences in eradication rate based on the age of the patient group. However, women had a considerably lower eradication rate for Helicobacter pylori (80.9% vs 70.7%, P< 0.001). This was even more evident in the 40s (86.2% vs 69.4%, P= 0.002) and 50s (80.9% vs 67.47%, P= 0.022). Conclusion: The eradication rate ofHelicobacter pylori has reduced compared to the past. There is no difference between the people living in rural and urban areas though medical facilities were different. However the eradication rate is significantly lower in women aged 40s and 50s; for those groups, it should be considered to use regimens longer than 7 days or increase the dose of the drugs.
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