Eradication rates of clarithromycin-resistant Helicobacter pylori using either rabeprazole or lansoprazole plus amoxicillin and clarithromycin
Open Access
- 17 October 2002
- journal article
- clinical trial
- Published by Wiley in Alimentary Pharmacology & Therapeutics
- Vol. 16 (11), 1933-1938
- https://doi.org/10.1046/j.1365-2036.2002.01368.x
Abstract
Background : The resistance of Helicobacter pylori to clarithromycin has become one of the primary reasons for eradication failure. Aim : To compare the eradication rates of triple therapy using amoxicillin (A), clarithromycin (C) and rabeprazole (R) or lansoprazole (L) against clarithromycin‐sensitive and clarithromycin‐resistant strains. Methods : Two hundred and ninety‐five patients were randomly divided into four groups and treated for 1 week: 147 cases were treated with RAC, i.e. 49 cases with R20C400 (10 mg R + 750 mg A + 200 mg C, twice daily), 48 cases with R40C400 (20 mg R + 750 mg A + 200 mg C, twice daily) and 50 cases with R40C800 (20 mg R + 750 mg A + 400 mg C, twice daily); 148 cases with treated with LAC (30 mg L + 750 mg A + 200 mg C, twice daily). Results : According to intention‐to‐treat and per protocol analyses, the eradication rates were 88% and 91% with RAC and 78% and 81% with LAC; the eradication rates with R20C400, R40C400 and R40C800 were 94%, 81% and 86%, respectively, in the intention‐to‐treat analysis. In addition, the eradication rates for clarithromycin‐sensitive strains with RAC and LAC were 98% and 89%, respectively, and for clarithromycin‐resistant strains with RAC and LAC were 8.1% and 0%, respectively. Conclusions : The eradication rate was significantly higher with RAC than LAC. The eradication rate for clarithromycin‐resistant strains was low in both groups, and an improved eradication rate could not be achieved by changing the dose of clarithromycin or proton pump inhibitor.Keywords
This publication has 21 references indexed in Scilit:
- Drug combinations with amoxycillin reduce selection of clarithromycin resistance during Helicobacter pylori eradication therapyInternational Journal of Antimicrobial Agents, 2002
- Effect of genotypic differences in CYP2C19 on cure rates for Helicobacter pylori infection by triple therapy with a proton pump inhibitor, amoxicillin, and clarithromycinClinical Pharmacology & Therapeutics, 2001
- genotype–related efficacy of omeprazole for the treatment of infection caused byClinical Pharmacology & Therapeutics, 1999
- A placebo‐controlled trial to assess the effects of 8 days of dosing with rabeprazole versus omeprazole on 24‐h intragastric acidity and plasma gastrin concentrations in young healthy male subjectsAlimentary Pharmacology & Therapeutics, 1998
- Clarithromycin-Resistant Helicobacter pylori in Patients With Duodenal Ulcer in the United StatesThe American Journal of Gastroenterology, 1998
- Comparison of rabeprazole 20 mg vs. omeprazole 20 mg in the treatment of active gastric ulcer—a European multicentre studyAlimentary Pharmacology & Therapeutics, 1998
- Eradication of Helicobacter pylori Using One‐week Triple Therapies Combining Omeprazole with Two Antimicrobials: The MACH I StudyHelicobacter, 1996
- A proton pump inhibitor, E3810, has antibacterial activity through binding toHelicobacter pyloriThe Esophagus, 1995
- Specific proton pump inhibitors E3810 and lansoprazole affect the recovery process of gastric secretion in rats differentlyBiochemical Pharmacology, 1994
- Effects of the Proton Pump Inhibitor, E3810, on Gastric Secretion and Gastric and Duodenal Ulcers or Erosions in RatsClinical Drug Investigation, 1991