[Retreatment of Helicobacter pylori infection with triple therapy after initial treatment failure].
OBJECTIVE
Helicobacter pylori (H. pylori) treatments fail at least in 10-20% of patients. However, retreatment strategies after failure of initial treatment have not been established. This study was conducted to evaluate the eradication rate of retreatment choices.


METHODS
Twenty-seven peptic ulcer patients who were retreated with OAC (omeprazole + amoxicillin + clarithromycin) or BMT (bismuth + metronidazole + tetracycline) after failure of BMT or OAC were included. Quadruple therapy (omeprazole + BMT) was also tried after failure of two successive triple therapies. Furthermore, the effect of resistance of metronidazole or clarithromycin on the eradication of H. pylori was evaluated.


RESULTS
Among 13 patients who were retreated with OAC after failure of BMT regimen, H. pylori was eradicated in 10 patients (76.9%). Among 14 patients retreated with BMT after failure of OAC regimen, H. pylori was eradicated in 11 patients (78.6%). Resistance of H. pylori to metronidazole or clarithromycin decreased the efficacy of BMT or OAC, respectively.


CONCLUSIONS
Eradication regimen should be decided considering the resistance to H. pylori. However, in case of unknown state of resistance, OAC can be chosen if BMT fails. Similarly, BMT can be tried in cases that OAC therapy failed. After failures of both triple therapies, quadruple therapy can be tried as the next step.
Kim
Nayoung
N
Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea. nayoungkim49@yahoo.co.kr
Lim
Seon Hee
SH
Lee
Kye Heui
KH
Koo
Myung Sook
MS
Kim
Jung Mogg
JM
Hwang
Jin-Hyeok
JH
Kim
Jin-Wook
JW
Lee
Dong Ho
DH
Jung
Hyun Chae
HC
Song
In Sung
IS
D000328:Adult; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D000897:Anti-Ulcer Agents / Q000008:administration & dosage*; D004359:Drug Therapy, Combination; D016481:Helicobacter Infections / Q000188:drug therapy*; D016480:Helicobacter pylori; D006801:Humans; D008297:Male; D008875:Middle Aged; D010437:Peptic Ulcer / Q000188:drug therapy* / Q000382:microbiology; D019233:Retreatment
D000900:Anti-Bacterial Agents; D000897:Anti-Ulcer Agents