Background:
Rabeprazole sodium is a proton pump inhibitor.
Aim:
To evaluate the efficacy and safety of 1‐week triple therapy with rabeprazole, amoxycillin and clarithromycin for the eradication of Helicobacter pylori.
Methods:
A total of 100 subjects with H. pylori were randomly divided into two groups of 1‐week triple therapy with rabeprazole 10 mg b.d., amoxycillin 750 mg b.d. and either clarithromycin 200 mg b.d. (RAC400, n=50) or clarithromycin 400 mg b.d. (RAC800, n=50). Endoscopic examination with four biopsies (two specimens from the antrum and two from the gastric body) was performed. The status of H. pylori infection was determined using culture and histology (Giemsa stain) of the biopsy specimens. Sensitivity to clarithromycin was determined using the E‐test: MIC > 8 g/mL was considered to be resistant, whereas MIC < 2 g/mL was considered to be sensitive. Cure was defined as no evidence of H. pylori infection 1 month after completion of treatment.
Results:
There were no significant differences in the clinical characteristics of the two groups. Eradication rates (intention‐to‐treat and per protocol, respectively) were: RAC400: 86% (95% CI: 76–95%) and 89% (95% CI: 80–97%); RAC800: 94% (95% CI: 87–100%) and 97% (95% CI: 94–100%). There was no significant difference between the eradication rates of either regimen. Three subjects with failed eradication in the RAC400 group were all infected with a clarithromycin‐resistant strain before beginning the therapy. Haemorrhagic colitis was the only severe adverse event, which was observed in one patient in the RAC800 group.
Conclusion:
One‐week triple therapy with rabeprazole, amoxycillin and low‐dose clarithromycin is effective for the eradication of H. pylori infection.
Aim:
To evaluate the efficacy and safety of two 1‐week low‐dose triple‐therapy drug regimens involving antisecretory drugs for Helicobacter pylori infection, 99␣patients with H. pylori infection were treated with either lansoprazole or ranitidine used together with clarithromycin and metronidazole.
Methods:
The drug combination and administration periods in the proton pump inhibitor group were lansoprazole 30 mg o.m., clarithromycin 200 mg b.d. and metronidazole 250 mg b.d., all given for 7 days (LCM group). The ranitidine group received ranitidine 150 mg b.d., clarithromycin 200 mg b.d. and metronidazole 250 mg b.d. also for 7 days (RCM group). The presence or absence of H. pylori was determined from gastric biopsy specimens taken from both the antrum and the body, by smear, culture and tissue section (Giemsa stain). Cure was defined as failure to find evidence of H. pylori infection 4 weeks after antimicrobial therapy had ended.
Results:
The cure of H. pylori infection was 88% in the LCM group (44 of 50; 95% confidence interval (CI) = 79–97%) and 92% in the RCM group (45 of 49; 95% CI = 84–99%). The incidence of adverse events was 16% and 18% for the two groups, respectively.
Conclusions:
No significant differences in cure rate and safety profiles were noted between the two regimens, suggesting that moderate acid inhibition using an H2‐blocker is sufficient to achieve optimal H. pylori eradication.
Our results indicate that for an accurate diagnosis and assessment, biopsies should be taken from the following four sites: the lesser curvatures of the mid-antrum (site 1) and middle body (site 3), and the greater curvatures of the mid-antrum (site 4) and middle body (site 6) of the stomach.
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