ABSTRACT
BACKGROUND/AIMS: We can expect to reduce costs and decrease adverse events by using low-dose triple therapy for H. pylori eradication. However, the efficacy of low-dose triple therapy for Koreans is questionable. In this study, we compared the efficacy of low-dose triple therapy with standard-dose triple therapy. METHODS: We enrolled 480 patients who were diagnosed as suffering with H. pylori infection via endoscopy with biopsy or CLO testing. Thirty patients were excluded due to malignancy or having undergone previous antibiotics medication. Two hundred and eighty patients received standard-dose triple therapy (pantoprazole 40 mg b.d, amoxicillin 1,000 mg b.d., and clarithromycin 500 mg b.d.), and 170 patients received low-dose triple therapy (pantoprazole 40 mg b.d., amoxicillin 750 mg b.d., and clarithromycin 250 mg b.d.). Eradication was evaluated 4~6 weeks after administering the medication. RESULTS: The H. pylori eradication rate was 77.9% in the standard-dose group, and 74.7% in the low-dose group. There was no significant difference in the H. pylori eradication rate between the two groups (p=0.444). The adverse events were significantly more frequent in the standard-dose group. One patient each in both groups discontinued medication because of an adverse event. CONCLUSIONS: The efficacy of low-dose therapy is similar to standard-dose therapy, and the adverse events are less frequent with low-dose therapy. This suggests that low-dose therapy would be preferred when considering the cost- benefit and low rate of adverse drug events.
Subject(s)
Humans , Amoxicillin , Anti-Bacterial Agents , Biopsy , Clarithromycin , Drug-Related Side Effects and Adverse Reactions , Endoscopy , Helicobacter pylori , HelicobacterABSTRACT
BACKGROUND: Helicobacter pylori is the single most common pathogen that causes chronic bacterial infection in human. The authors designed a new type of urease detection method (Asan Helicobacter test) that can be used for rapid early detection of H. pylori as well as a transport medium. This medium has a strong acidity with a minimal concentration of urea for the purpose of the detection of H. pylori. The current study was to evaluate the bacteriological and clinical usefulness of this medium. METHOD: 252 antral biopsies from patients underwent upper gastrointestinal endoscopies in Inha University Hospital were inserted Asan Helicobacter Test and CLO test. 37 antral biopsies from patients underwent upper gastrointestinal endoscopies in Konyang University Hospital were inserted Asan Helicobacter Test. Biopsies were cultured on nonselective media only. RESULT: The sensitivity and specificity of the Asan Helicobacter test were comparable with the CLO test (88.0% and 94.0%, respectively), and the results agreed in 99.2% of 252 cases with the CLO test. With this transport medium, all 23 specimens that showed positive reaction among 37 patients yielded satisfactory isolation of H. pylori. CONCLUSION: These findings suggest that the reagent in the kit inhibit the growth of microbial contaminant due to low pH and do not suppresses growth of H. pylori due to low concentration of urea. This kit may be used as a transport medium as well as a rapid urease test for H. pylori.