There are 5 clinical trials
1. Back ground Antibiotics resistance of Helicobacter pylori, especially to clarithromycin is one of the main causes of failure of eradication. 23S rRNA point mutation of Helicobacter pylori is associated clarithromycin resistance 2. Hypothesis If the investigators check the 23S rRNA point mutation then choose treatment regimens containing a proton pump inhibitor and combination of two antibiotics (amoxicillin and clarithromycin or metronidazole), the investigators will eradicate Helicoabacter pylori more successfully 3. Material & methods The investigators enroll patients diagnosed with peptic ulcer, endoscopically. Helicobacter pylori is documented with Urea breath test or silver staining biopsy specimen or polymerase chain reaction of biopsy specimen. Check the 23S rRNA A2142G/A2143G point mutation by polymerase chain reaction. If there is mutation, the investigators consider as resistance to clarithromycin and choose the treatment regimen containing a proton pump inhibitor, amoxicillin, metronidazole. If there is no mutation, choose the treatment regimen containing a proton pump inhibitor, amoxicillin, clarithromycin. Verify Helicobacter pylori eradication by urea breath test. Compare eradication rate with conventional treatment,proton pump inhibitor, amoxicillin, clarithromycin.
Check the 23S rRNA A2142G/A2143G point mutation by polymerase chain reaction. --- A2143G ---
Description: Eradication was determined by the C13-urea breath test 6 to 8 weeks after the eradication therapy when PPIs had not been used for at least 2 weeks.Measure: Helicobacter Pylori Eradication Rate Time: 8 weeks
The goal of this trial is to compare the non-inferiority efficacy and safety of two different treatment schemes: pantoprazole 80 mg + levofloxacin 500 mg + azithromycin 500 mg once daily (PLA, test) vs. clarithromycin 500 mg + lansoprazole 30 mg + amoxicillin 1 g twice daily (CLA, reference), each during 10 days, over Helicobacter Pylori (HP) eradication. Both schemes will be tested in treatment-naive patients, with biopsy-based diagnosis for HP infection. One month after finishing each treatment, C13-urea breath testing will be required to verify HP eradication. Biopsies will also be taken to identify Clarithromycin-resistance mutations in HP strains by fluorescence in situ hybridization (FISH).
The probe for H. pylori identification (Hpy 1) (5'CACACCTGACTGACTATCCCG-3') will be labeled with fluorescein isothiocyanate (FITC) that provides a green signal, and the probes that detect the three most prevalent clarithromycin-resistance mutations (ClaR1 (A2143G) 5'CGGGGTCTTCCCGTCTt-3', ClaR2 (A2144G) 5'CGGGGCTCTCCGTCTT-3', and ClaR3 (A21443C) 5-CGGGGTCTTGCCGTCTT-3') will be labeled with red fluorochrome (Cy3). --- A2143G ---
The purpose of this study was to evaluate the efficacy and compliance of tailored therapy which using the polymerase chain reaction for point mutation of clarithromycin, compared to concomitant therapy, in patients without history of H. pylori eradication.
Method> Patients with H. pylori infection who have been screened for a 23S ribosomal RNA point mutation (A2142G, A2143G point mutation) and randomized to a concomitant treatment group and a tailored treatment group. --- A2142G --- --- A2143G ---
Description: Comparison of percentage of people who succeeded in H. pylori eradication among all participants in each treatment group (tailored therapy vs concomitant therapy)Measure: Comparison of success rate of H. pylori eradication between tailored therapy and concomitant therapy. Time: At 4 weeks after the completion of drug administration, the urea breath test is performed to check for eradication, Before the urea breath test, the proton pump inhibitor or H2 blocker should be discontinued for 2 weeks.
Description: Identify the effect of 23S ribosomal RNA point mutation on the eradication rate regardless of the administration drug.Measure: Difference in eradication rate according to the frequency of 23S ribosomal RNA point mutation in clarithromycin Time: Before the treatment, 23S ribosomal RNA point mutation is confirmed and at least 4 weeks after the end of treatment, urea breath test is performed to check whether or not eradication is completed.
Description: After taking the treatment drug, take out all remaining medicine in the outpatient clinic room, check the number of remaining medicines, and judge compliance.Measure: Number of remaining medicines of tailored therapy compared to concomitant therapy Time: At 4 weeks after the completion of drug administration, when the patient visited for the urea breath test, check the number of remaining medicines.
The investigators investigated the point mutations in the 23S rRNA genes of patients infected with clarithromycin-resistant H. pylori and compared the H. pylori eradication rates based on the identified clinically significant point mutations.
Inclusion Criteria: - Clinical diagnosis of Helicobacter pylori infection Exclusion Criteria: - H. pylori eradication therapy within 1 year, - antibiotics within 4 weeks, - surgery for gastric cancer - malignant tumors other than gastric cancer - end-stage renal disease - liver cirrhosis, - pregnancy Inclusion Criteria: - Clinical diagnosis of Helicobacter pylori infection Exclusion Criteria: - H. pylori eradication therapy within 1 year, - antibiotics within 4 weeks, - surgery for gastric cancer - malignant tumors other than gastric cancer - end-stage renal disease - liver cirrhosis, - pregnancy Helicobacter Pylori Infection Antibiotic Resistant Strain Sprains and Strains Sequencing-based detection of point mutations identified four mutations that were considered clinically significant (A2142G, A2142C, A2143G, A2143C), while all the other mutations were considered clinically insignificant. --- A2142G --- --- A2142C --- --- A2143G ---
Description: Number of participant with successful Helicobacter pylori eradicationMeasure: Helicobacter pylori eradication rate Time: 2 year
We aimed to compare the efficacy of genotypic resistance-guided tailored therapy vs empirical therapy for eradication of Helicobacter pylori (H. pylori) infection in randomized controlled trials.
This is a method to confirm the mutation of A2142G and A2143G by PCR, which are known to be highly related to the resistance of clarithromycin 23S rRNA point mutation. --- A2142G --- --- A2143G ---
Description: Eradication rate of H. pylori infectionMeasure: Eradication rate Time: 13C-UBT at least 4 weeks after completion of treatment