Clinical Endoscopy

The Korean Society of Gastrointestinal Endoscopy (대한소화기내시경학회)
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Effect of Additional Ecabet Sodium on Conventional Triple Therapy for Helicobacter pylori Eradication in Korea

Ecabet Sodium의 추가가 Helicobacter pylori 일차 삼제 요법의 제균율에 미치는 효과

  • Kim, Ji-Yeon (Department of Internal Medicine, Seoul National University College of Medicine) ;
  • Lee, Dong-Ho (Department of Internal Medicine, Seoul National University Bundang Hospital) ;
  • Son, Jun-Hyuk (Department of Internal Medicine, Seoul National University College of Medicine) ;
  • Kim, Jae-Yeon (Department of Internal Medicine, Seoul National University College of Medicine) ;
  • Kwon, Ji-Eun (Department of Internal Medicine, Seoul National University College of Medicine) ;
  • Park, Young-Soo (Department of Internal Medicine, Seoul National University Bundang Hospital) ;
  • Kim, Na-Young (Department of Internal Medicine, Seoul National University Bundang Hospital) ;
  • Shin, Cheol-Min (Department of Internal Medicine, Seoul National University Bundang Hospital) ;
  • Jung, Hyun-Chae (Department of Internal Medicine, Seoul National University College of Medicine) ;
  • Song, In-Sung (Department of Internal Medicine, Seoul National University College of Medicine)
  • 김지연 (서울대학교 의과대학 내과학교실) ;
  • 이동호 (분당서울대학교병원 내과) ;
  • 손준혁 (서울대학교 의과대학 내과학교실) ;
  • 김재연 (서울대학교 의과대학 내과학교실) ;
  • 권지은 (서울대학교 의과대학 내과학교실) ;
  • 박영수 (분당서울대학교병원 내과) ;
  • 김나영 (분당서울대학교병원 내과) ;
  • 신철민 (분당서울대학교병원 내과) ;
  • 정현채 (서울대학교 의과대학 내과학교실) ;
  • 송인성 (서울대학교 의과대학 내과학교실)
  • Published : 2011.06.30
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Abstract

Background/Aims: Ecabet sodium is known for its bactericidal effect against H. pylori. It was reported that a supplement of ecabet sodium to conventional triple therapy showed good results in Asia. The Aim of this study was to ascertain the efficacy of additional ecabet sodium on conventional triple therapy for eradication of H. pylori. Methods: We reviewed the cases of 111 patients (Group A) with H. pylori infection who received ecabet sodium with triple therapy (20 mg of rabeprazole, 1 g of amoxicillin, 500 mg of clarithromycin and 1 g of ecabet sodium, twice daily for 7 days). Another 186 patients (Group B) received PPI-based triple therapy (same as the above, except without the ecabet sodium). Eradication was evaluated 4 weeks later after completion of treatment by $^{13}C$-UBT. Results: Eradication rates were 74.8% (83/111) in group A and 70.4% (131/186) in group B by intention-to-treat analysis (p=0.420), and 75.2% (82/109) in group A and 70.7% (128/181) in group B by per protocol analysis (p=0.405). Conclusions: The addition of ecabet sodium to conventional triple therapy did not increase the eradication rate of H. pylori in this study. These findings imply that ecabet sodium as an additional agent cannot overcome antibiotic resistance, which is the most important cause of failure of triple therapy.

목적: Ecabet sodium은 Helicobacter pylori에 대하여 항균성을 가지고 있다. 최근 아시아에서 ecabet sodium을 기존의 프로톤펌프 억제제를 기반으로 하는 삼제 요법에 추가하여 제균율을 증가시켰다는 보고들이 있다. 본 연구에서는 한국인 환자에서 ecabet sodium을 삼제 요법에 추가하여 H. pylori의 제균율에 대한 영향을 확인하고자 하였다. 대상 및 방법: H. pylori에 감염된 환자들 중 111명은 기존의 삼제요법에 ecabet sodium을 추가하여 치료하였고(rabeprazole 20 mg, amoxicillin 1 g, clarithromycin 500 mg, ecabet sodium 1 g, 1일 2회, 7일 간)(Group A), 186명은 삼제 요법으로 치료하였다(rabeprazole 20 mg, amoxicillin 1 g, clarithromycin 500 mg, 1일 2회, 7일간)(Group B). 투약이 완료된 4주 뒤에 제균 여부를 $^{13}C$-요소 호기 검사로 확인하였다. 결과: 결과는 후향적으로 분석하였고, 제균율은 intention to treat 분석 시 Group A에서 74.8%(83/111)였고, Group B에서 70.4%(131/186)(p=0.420)이었다. Per protocol 분석 시에는 Group A에서 75.2%(82/109)였고, Group B에서 70.7%(128/181)(p=0.405)이었다. 결론: 본 연구에서는 Ecabet sodium을 기존의 프로톤펌프 억제제를 기반으로 하는 삼제 요법에 추가하여도 제균율이 증가하지 않았다. 이것은 ecabet sodium의 추가가 최근의 항생제 내성을 극복하지 못한 것으로 생각된다.

Keywords

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