Abstract
We evaluated the efficacy and tolerability of a dual therapy with rabeprazole and amoxicillin (AMX) as an empiric third-line rescue therapy. In patients with failure of first-line treatment with a proton pump inhibitor (PPI)-AMX-clarithromycin regimen and second-line treatment with the PPI-AMX-metronidazole regimen, a third-line eradication regimen with rabeprazole (10 mg q.i.d.) and AMX (500 mg q.i.d.) was prescribed for 2 wk. Eradication was confirmed by the results of the 13C-urea breath test (UBT) at 12 wk after the therapy. A total of 46 patients were included; however, two were lost to follow-up. The eradication rates as determined by per-protocol and intention-to-treat analyses were 65.9% and 63.0%,respectively. The pretreatment UBT results in the subjects showing eradication failure; those patients showing successful eradication comprised 32.9 ± 28.8 permil and 14.8 ± 12.8 permil, respectively. The pretreatment UBT results in the subjects with eradication failure were significantly higher than those in the patients with successful eradication (P= 0.019). A low pretreatment UBT result (≤ 28.5 permil) predicted the success of the eradication therapy with a positive predictive value of 81.3% and a sensitivity of 89.7%. Adverse effects were reported in 18.2% of the patients, mainly diarrhea and stomatitis. Dual therapy with rabeprazole and AMX appears to serve as a potential empirical third-line strategy for patients with low values on pretreatment UBT.
| Original language | English |
|---|---|
| Pages (from-to) | 2735-2738 |
| Number of pages | 4 |
| Journal | World Journal of Gastroenterology |
| Volume | 18 |
| Issue number | 21 |
| DOIs | |
| Publication status | Published - 2012 Jun |
Fingerprint
Keywords
- Amoxicillin
- Dual therapy
- Eradication
- Helicobacter pylori
- Urea breath test
ASJC Scopus subject areas
- Gastroenterology
Cite this
Dual therapy for third-line helicobacter pylori eradication and urea Breath test prediction. / Nishizawa, Toshihiro; Suzuki, Hidekazu; Maekawa, Takama; Harada, Naohiko; Toyokawa, Tatsuya; Kuwai, Toshio; Ohara, Masanori; Suzuki, Takahiro; Kawanishi, Masahiro; Noguchi, Kenji; Yoshio, Toshiyuki; Katsushima, Shinji; Tsuruta, Hideo; Masuda, Eiji; Tanaka, Munehiro; Katayama, Shunsuke; Kawamura, Norio; Nishizawa, Yuko; Hibi, Toshifumi; Takahashi, Masahiko.
In: World Journal of Gastroenterology, Vol. 18, No. 21, 06.2012, p. 2735-2738.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Dual therapy for third-line helicobacter pylori eradication and urea Breath test prediction
AU - Nishizawa, Toshihiro
AU - Suzuki, Hidekazu
AU - Maekawa, Takama
AU - Harada, Naohiko
AU - Toyokawa, Tatsuya
AU - Kuwai, Toshio
AU - Ohara, Masanori
AU - Suzuki, Takahiro
AU - Kawanishi, Masahiro
AU - Noguchi, Kenji
AU - Yoshio, Toshiyuki
AU - Katsushima, Shinji
AU - Tsuruta, Hideo
AU - Masuda, Eiji
AU - Tanaka, Munehiro
AU - Katayama, Shunsuke
AU - Kawamura, Norio
AU - Nishizawa, Yuko
AU - Hibi, Toshifumi
AU - Takahashi, Masahiko
PY - 2012/6
Y1 - 2012/6
N2 - We evaluated the efficacy and tolerability of a dual therapy with rabeprazole and amoxicillin (AMX) as an empiric third-line rescue therapy. In patients with failure of first-line treatment with a proton pump inhibitor (PPI)-AMX-clarithromycin regimen and second-line treatment with the PPI-AMX-metronidazole regimen, a third-line eradication regimen with rabeprazole (10 mg q.i.d.) and AMX (500 mg q.i.d.) was prescribed for 2 wk. Eradication was confirmed by the results of the 13C-urea breath test (UBT) at 12 wk after the therapy. A total of 46 patients were included; however, two were lost to follow-up. The eradication rates as determined by per-protocol and intention-to-treat analyses were 65.9% and 63.0%,respectively. The pretreatment UBT results in the subjects showing eradication failure; those patients showing successful eradication comprised 32.9 ± 28.8 permil and 14.8 ± 12.8 permil, respectively. The pretreatment UBT results in the subjects with eradication failure were significantly higher than those in the patients with successful eradication (P= 0.019). A low pretreatment UBT result (≤ 28.5 permil) predicted the success of the eradication therapy with a positive predictive value of 81.3% and a sensitivity of 89.7%. Adverse effects were reported in 18.2% of the patients, mainly diarrhea and stomatitis. Dual therapy with rabeprazole and AMX appears to serve as a potential empirical third-line strategy for patients with low values on pretreatment UBT.
AB - We evaluated the efficacy and tolerability of a dual therapy with rabeprazole and amoxicillin (AMX) as an empiric third-line rescue therapy. In patients with failure of first-line treatment with a proton pump inhibitor (PPI)-AMX-clarithromycin regimen and second-line treatment with the PPI-AMX-metronidazole regimen, a third-line eradication regimen with rabeprazole (10 mg q.i.d.) and AMX (500 mg q.i.d.) was prescribed for 2 wk. Eradication was confirmed by the results of the 13C-urea breath test (UBT) at 12 wk after the therapy. A total of 46 patients were included; however, two were lost to follow-up. The eradication rates as determined by per-protocol and intention-to-treat analyses were 65.9% and 63.0%,respectively. The pretreatment UBT results in the subjects showing eradication failure; those patients showing successful eradication comprised 32.9 ± 28.8 permil and 14.8 ± 12.8 permil, respectively. The pretreatment UBT results in the subjects with eradication failure were significantly higher than those in the patients with successful eradication (P= 0.019). A low pretreatment UBT result (≤ 28.5 permil) predicted the success of the eradication therapy with a positive predictive value of 81.3% and a sensitivity of 89.7%. Adverse effects were reported in 18.2% of the patients, mainly diarrhea and stomatitis. Dual therapy with rabeprazole and AMX appears to serve as a potential empirical third-line strategy for patients with low values on pretreatment UBT.
KW - Amoxicillin
KW - Dual therapy
KW - Eradication
KW - Helicobacter pylori
KW - Urea breath test
UR - http://www.scopus.com/inward/record.url?scp=84863093027&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84863093027&partnerID=8YFLogxK
U2 - 10.3748/wjg.v18.i21.2735
DO - 10.3748/wjg.v18.i21.2735
M3 - Article
C2 - 22690086
AN - SCOPUS:84863093027
VL - 18
SP - 2735
EP - 2738
JO - World Journal of Gastroenterology
JF - World Journal of Gastroenterology
SN - 1007-9327
IS - 21
ER -