소화성 궤양환자에서 일주일 삼중병합요법에 의한 H. pylori의 제균효과

• Published in: The Korean journal of gastroenterology Vol. 30; no. 1; pp. 164 - 172
• Main Authors: 이진관, Jin Kwan Lee, 김선영, Sun Young Kim, 박경현, Gyeng Hyen Park, 이종현, Jong Hyun Lee, 이덕영, Duk Young Lee, 허충, Chung Hur
• Format: Journal Article
• Language: Korean
• Published: 대한소화기학회 1997
• Subjects: Eradication; H. pylori; Mertonidazole
• ISSN: 1598-9992

Background/Aims: Since eradication of H. pylori proved to prevent the recunence of peptic ulcer disease, numerous therapeutic trials have been introduced. One of them, MOC (metronidazole, omeprazole, clarithromycin) protocol seems to be very desirable and widely recommended because of its high eradication rate, short term treatment and good drug compliance. The aim of this study was to evaluate the efficacy of this therapeutic modality in Korean patients. Methods: One hundred and fourteen patients including 72 patients ot' duodenal ulcer, 27 of gastric ulcer, 2 of pyloric channe] ulcer, and 13 of combined ulcer were included. The patients received omeprazole 40 mg, clarithroycin 500 mg, and tinidazole 1,050 mg daily for 7 days. Endoscopy was performed 1 moonth after the end of treatment and then biopsy specimens were taken in antrum near the pylorus. Urease test and Warthin Starry silver stain were conducted concordantly. Also the patients were asked whether they experienced any untoward effects by this regimen. Results: One hundred and eight out of 114 patients were healed of their ulcers, representing 94.7% of ulcer healing rate. The eradication rate of H. pylori was 93.0%. No statistic difference of H. pylori eradication rate was seen among age, site of ulcer, number of bacteria, and history nf recurrence. But low eradication rate was observed in female gender. Tolerabilty to this regimen was good and most of the patients were satisfied. No severe untoward side effect was seen. Conclusions: Seven day MOC regimen turned out effective and tolerable for eradication of H. pylor and healing of peptic u]cer. Good drug compliance seems to be based on short course of treatmment, b.i.d regimen and lower doses of the antibiotics. But low eradication rate in female gencler which seems probably to have metronidazole resistence requires further study. So it should be considered that regimens including metronidazole such as MOC would not be acceptable in Korean women who had previously been exposed to metronidazole. (Korean J Gastroenterol 1997; 30;164- 172)