"Personalized Antibacterial Treatment Can Increase Success Rate of 'Helicobacter' Therapy"

Research by Professor Joonhyung Cho at Soonchunhyang University Seoul Hospital
Customized Drug Prescription After Antibiotic Resistance Testing
96% Final Treatment Success Rate with Second-Line Therapy

Professor Joonhyung Cho, Department of Gastroenterology, Soonchunhyang University Seoul Hospital.

[Asia Economy Reporter Lee Gwan-joo] A study has found that tailored eradication therapy for Helicobacter pylori-infected patients results in a higher treatment success rate.

Suncheonhyang University Seoul Hospital announced on the 7th that Professor Cho Jun-hyung of the Department of Gastroenterology explained this through a paper titled "Comparative Study of Tailored Eradication Therapy and Modified Bismuth Quadruple Therapy in Helicobacter pylori Treatment," published in the latest issue of the international SCI journal Expert Review of Anti-Infective Therapy.

In the study conducted over 3 years and 8 months, 251 patients diagnosed with Helicobacter infection during endoscopic examination were treated with either classical eradication therapy or individualized tailored therapy. In the classical eradication therapy group of 124 patients, the conventional empirical first-line drugs (amoxicillin, metronidazole, etc.) were prescribed, whereas in the tailored therapy group of 127 patients, eradication drugs were selected based on the results of the molecular biological test DPO-PCR to determine resistance to clarithromycin. Tailored eradication therapy was administered to avoid resistance in cases with point mutations A2142G or A2143G.

As a result, the treatment success rate of the tailored therapy ranged from 89.0% to 92.7%, significantly higher than the 76.5% in the classical therapy group. When secondary therapy was also applied, the final success rate was confirmed to be 96.0%. Drug-related side effects were mostly mild, occurring at a rate of 16.8%, significantly lower than the 25.6% in the classical therapy group, improving patient treatment compliance. The research team anticipated that if tailored Helicobacter eradication therapy is widely applied in clinical practice alongside endoscopic examination, it would increase success rates and reduce treatment side effects, resulting in excellent overall cost-effectiveness.

Professor Cho stated, "With the national cancer screening program conducting gastroscopy every two years for adults aged 40 and over, the number of Helicobacter tests has rapidly increased. Recently, eradication therapy is recommended for patients testing positive as a cancer prevention measure according to international guidelines. However, without knowing antibiotic resistance status, the frequently prescribed first-line therapy currently has a low eradication success rate of about 75%, causing inconvenience as patients must undergo secondary therapy as well."

He added, "If antibiotic resistance status is known before treatment through DPO-PCR molecular testing, unnecessary prescriptions can be avoided and efficient personalized tailored therapy can be provided. Therefore, when Helicobacter testing is performed in endoscopy rooms, attention to the 'test-and-treat' strategy is necessary."

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