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Korean J Gastroenterol  <  Volume 72(5); 2018 <  Articles

The Korean Journal of Gastroenterology 2018; 72(5): 237-244  https://doi.org/10.4166/kjg.2018.72.5.237
New Helicobacter pylori Eradication Therapies
Jae Yong Park and Jae Gyu Kim
Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Korea
Correspondence to: Jae Gyu Kim
Received: October 1, 2018; Revised: October 20, 2018; Accepted: October 29, 2018; Published online: November 25, 2018.
© The Korean Journal of Gastroenterology. All rights reserved.

Abstract
While the prevalence of Helicobacter pylori (H. pylori) infection is decreasing in Korea, the incidence of gastric cancer remains high, emphasizing the importance of H. pylori eradication. A new treatment strategy is needed as the eradication rate with standard triple therapy, which is currently the standard first-line regimen for H. pylori infection, has decreased below the optimum level. The major cause of eradication failure is increased antibiotic resistance. Sequential, concurrent, and hybrid therapies that include clarithromycin produce higher eradication rates than conventional standard triple therapy. However, the effectiveness of these treatments is limited in regions where the resistance rate to various antibiotics is high. Bismuth quadruple therapy is another alternative therapy, but again the eradication rate is not sufficiently high. Tailored therapy based on individual characteristics, including antibiotic susceptibility, may be ideal, but there are several limitations for clinical application and further research is needed. New potassium-competitive acid blocker-based therapies could emerge as effective alternatives in the near future. A consensus is needed to establish a strategy for applying new eradication therapies in Korea.
Keywords: Helicobacter pylori; Therapeutics; Guideline; Korea


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