Dual therapy with high doses of rabeprazole and amoxicillin versus triple therapy with rabeprazole, amoxicillin, and metronidazole as a rescue regimen for Helicobacter pylori infection after the standard triple therapy.

Abstract:

BACKGROUNDS AND AIMS:Development of safe and effective rescue regimens for eradication failure of Helicobacter pylori infection by standard regimens is an urgent task. We designed the prospective study to compare the efficacy of two rescue regimens after eradication failure by the standard triple therapy. METHODS:One hundred and thirty-two patients in whom eradication of H. pylori infection failed initial triple therapy with lansoprazole 30 mg b.i.d, amoxicillin 750 mg b.i.d. and clarithromycin 400 mg b.i.d. for 1 week were randomized to either the 1-week triple therapy with rabeprazole 10 mg b.i.d., amoxicillin 750 mg b.i.d., and metronidazole 250 mg b.i.d. (RAM) or the 2-week dual therapy with rabeprazole 10 mg q.i.d. and amoxicillin 500 mg q.i.d. (RA). Eradication of H. pylori was judged by (13)C-urea breath test 1 month later. RESULTS:The intention-to-treat and per-protocol-based eradication rates were 92.4% (95% CI: 83.2-97.5) and 95.3% (95% CI: 86.9-99.0) for the RAM therapy and 90.9% (95% CI: 81.2-96.6) and 93.8% (95% CI: 84.8-98.3), respectively, for the RA therapy (P > 0.2 for both). No clinically recognizable adverse events were observed with either regimen. CONCLUSION:RA as well as RAM therapy are safe and effective rescue regimens for H. pylori infection after eradication failure by the standard triple therapy.

journal_name

Eur J Clin Pharmacol

authors

Shirai N,Sugimoto M,Kodaira C,Nishino M,Ikuma M,Kajimura M,Ohashi K,Ishizaki T,Hishida A,Furuta T

doi

10.1007/s00228-007-0302-8

subject

Has Abstract

pub_date

2007-08-01 00:00:00

pages

743-9

issue

8

eissn

0031-6970

issn

1432-1041

journal_volume

63

pub_type

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