우리나라 Helicobacter pylori 제균치료의 현재 전략

ince the development of guidelines for the diagnosis and treatment of Helicobacter pylori infection in 1998, the Korean College of Helicobacter and Upper Gastrointestinal Research proposed revised guidelines in 2009 and 2013. The revised guideline in 2013 recommends triple therapy including conventional proton pump inhibitor (PPI), clarithromycin, and amoxicillin for 7 days as the primary eradication regimen. When clarithromycin resistance is suspected, quadruple therapy including PPI, metronidazole, bismuth, and tetracycline for 7∼14 days is recommended as an alternative primary regimen for H. pylori eradication. Bismuth-containing quadruple therapy is recommended in cases of H. pylori eradication failure when the initial treatment was triple therapy. When initial bismuth-containing quadruple therapy fails to eradicate H. pylori, it is very difficult to create a secondary regimen. There is paucity of evidence regarding these secondary regimens. In addition, due to the declining eradication rates of primary regimens in recent years, other potential combinations including sequential and concomitant therapies have been considered. KCI Citation Count: 2