Significance of Pretreatment Delta 13CO2 as Predictor of Success for H. Pylori Eradication

초록

Backgrounds and Aims: Recently, several studies have shown that a high δ13CO2value in 13C-urea breath test(13C-UBT), representing increased bacterial density of Helicobacter pylori (H. pylori), is associated with a significant reduction in the eradication rate of H. pylori. And also, efficacy of triple therapy with omeprazole, amoxicillin, and clarithromycin (OAC) varies among different geographic regions and patient populations. We assessed the efficacy of the OAC regimen according to the treatment duration (7, 10 or 14 days) using 13C-UBT in Korea, and studied the significance of pre-treatment δ13CO2as predictor of success for H. pylori eradication. Method: 387 H. pylori positive patients (224 male and 163 female; mean age of 50.2 years, range of 18-86) with peptic ulcer were randomly assigned to a OAC (omeprazole 20mg b.d., amoxycillin 1.0g b.d. and clarithromycin 500mg b.d.) 7, 10 or 14 days regimen. Eradication of H. pylori infection was assessed by 13C-UBT 4 weeks after completion of therapy. Patients with taking drugs, which affect the result of 13C-UBT, within a month preceding the study, and those with poor compliance (< 80% of medications taken) were excluded in the study. Results: No significant difference was detected in pre-treatment δ13CO2for the three groups (53.9±31.3 ¢¶ , 41.5±27.8 ¢¶ , 44.7±27.5 ¢¶ ). The eradication rates of H. pylori according to the pre-treatment δ13CO2in each group are shown in the following table. Conclusions: Overall eradication rate of H. pylori was highest in OAC 14 regimen in Korean patients. And pretreatment δ13CO2value may be considered as a factor that predicts failure of treatment for H. pylori.