Rabeprazole, amoxycillin and low‐ or high‐dose clarithromycin for cure of Helicobacter pylori infection

Abstract

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.

Safety and efficacy of 7‐day rabeprazole‐ and omeprazole‐based triple therapy regimens for the eradication of Helicobacter pylori in patients with documented peptic ulcer disease

“…[12][13][14][15] In terms of H. pylori eradication, the effectiveness of rabeprazole-based triple therapy has been shown in patients with chronic gastritis, peptic ulcer disease and non-ulcer dyspepsia. [16][17][18][19][20] The present study was designed to determine whether rabeprazole, in combination with clarithromycin and either amoxicillin or metronidazole, is therapeutically equivalent to the same omeprazole-based regimens in the eradication of H. pylori in subjects with documented peptic ulcer disease and H. pylori infection.…”

Omeprazole-based triple therapy with low-versus high-dose of clarithromycin plus amoxicillin forH pylorieradication in Iranian population

“…On the basis of proton pump inhibitor b.i.d regimens, the H pylori eradication rates by pooled PP analysis were 86.1% and 89.6% in the clarithromycin 250mg b.i.d and 500 mg b.i.d regimens, respectively. In contrast, a recent Japanese study showed that clarithromycin 200 mg b.i.d regimen was as effective as 400 mg b.i.d [18] . In addition, a multi-center study performed in France demonstrated a somewhat higher, although not significant, eradication rate with lowdose clarithromycin triple therapy compared with the conventional regimen [17] .…”

“…As this regimen is costly for routine use in developing countries, dose reduction is an option to decrease its cost. There are limited studies that have evaluated the efficacy of both clarithromycin and amoxicillin in low-dose regimens in H pylori eradication with a PPI-based triple therapy [15][16][17][18][19] . Therefore, we tried to investigate the efficacy and tolerability of omeprazole-based triple therapy with high and low doses of clarithromycin and amoxicillin in H pylori eradication in Iranian population.…”

Resistance to Antimicrobialagents in Eradication of Helicobacter Pylori Infection

“…In addition, several studies have indicated that there are no significant differences in the rate of eradication among different doses of RPZ as a PPI, 10mg, 20mg, and 40mg (Hokari, Sugiyama et al, 2001;Miwa, Yamada et al, 2000). Similarly, there were no significant differences in the rate of eradication between 2 doses of CAM: 400mg and 800mg Hokari, Sugiyama et al, 2001;Kihira, Satoh et al, 2000).…”