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Five-day proton pump inhibitor-based quadruple therapy regimen is more effective than 7-day triple therapy regimen for Helicobacter pylori infection.

AbstractBACKGROUND:
There have been no reports that describe whether 5-day quadruple therapy (rabeprazole + amoxicillin + clarithromycin + metronidazole; RACM) could substitute for standard 7-day triple therapy as a first-line therapy for Helicobacter pylori.
PATIENTS AND METHODS:
This study was designed as a randomized prospective single centre study. A total of 160 H. pylori-positive patients who had not received therapy were given either a 5-day RACM regimen (n=80, rabeprazole 20 mg b.d., amoxicillin 750 mg b.d., clarithromycin 200 mg b.d. and metronidazole 250 mg b.d.) or a 7-day RAC regimen (n=80, rabeprazole 20 mg b.d., amoxicillin 750 mg b.d. and clarithromycin 200 mg b.d.). Cure of the infection was assessed by a (13)C urea breath test 1 month after the completion of therapy.
RESULTS:
The eradication rates of the 5-day RACM regimen and the 7-day RAC regimen were 93% (95% CI: 84--97%) and 81% (95% CI: 71--89%) by intention-to-treat analysis, 94% (95% CI: 86--98%) and 83% (95% CI: 73--91%) by all-patients-treated analysis analysis and 95% (95% CI: 87--98%; P < 0.05) and 82% (95% CI: 72--90%) by per protocol analysis, respectively. No serious adverse effect was observed, and 99% of the patients reported complete compliance.
CONCLUSIONS:
The cure rate of the 5-day RACM regimen was more effective than the 7-day RAC regimen, suggesting that this regimen could be preferable as a first-line therapy for H. pylori infection.
AuthorsA Nagahara, H Miwa, T Yamada, A Kurosawa, R Ohkura, N Sato
JournalAlimentary pharmacology & therapeutics (Aliment Pharmacol Ther) Vol. 15 Issue 3 Pg. 417-21 (Mar 2001) ISSN: 0269-2813 [Print] England
PMID11207518 (Publication Type: Clinical Trial, Comparative Study, Journal Article, Randomized Controlled Trial)
Chemical References
  • 2-Pyridinylmethylsulfinylbenzimidazoles
  • Anti-Bacterial Agents
  • Anti-Infective Agents
  • Anti-Ulcer Agents
  • Benzimidazoles
  • Carbon Isotopes
  • Penicillins
  • Metronidazole
  • Rabeprazole
  • Amoxicillin
  • Clarithromycin
  • Omeprazole
Topics
  • 2-Pyridinylmethylsulfinylbenzimidazoles
  • Administration, Oral
  • Adolescent
  • Adult
  • Aged
  • Amoxicillin (administration & dosage, pharmacology)
  • Anti-Bacterial Agents (administration & dosage, pharmacology)
  • Anti-Infective Agents (administration & dosage, pharmacology)
  • Anti-Ulcer Agents (administration & dosage, pharmacology)
  • Benzimidazoles (administration & dosage, pharmacology)
  • Breath Tests
  • Carbon Isotopes
  • Clarithromycin (administration & dosage, pharmacology)
  • Drug Administration Schedule
  • Drug Therapy, Combination
  • Female
  • Helicobacter Infections (drug therapy, pathology)
  • Humans
  • Male
  • Metronidazole (administration & dosage, pharmacology)
  • Middle Aged
  • Omeprazole (analogs & derivatives)
  • Penicillins (administration & dosage, pharmacology)
  • Rabeprazole
  • Treatment Outcome

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