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Efficacy of triple therapy comprising rabeprazole, amoxicillin and metronidazole for second‐line Helicobacter pylori eradication in Japan , and the influence of metronidazole resistance
Author(s) -
Murakami K.,
Sato R.,
Okimoto T.,
Nasu M.,
Fujioka T.,
Kodama M.,
Kagawa J.
Publication year - 2003
Publication title -
alimentary pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.308
H-Index - 177
eISSN - 1365-2036
pISSN - 0269-2813
DOI - 10.1046/j.1365-2036.2003.01401.x
Subject(s) - metronidazole , amoxicillin , rabeprazole , helicobacter pylori , clarithromycin , medicine , gastroenterology , antibiotics , drug resistance , proton pump inhibitor , microbiology and biotechnology , pharmacology , biology
Summary Background : The widespread use of eradication therapy for Helicobacter pylori in Japan has led to an increase in antibiotic‐resistant strains and the problem of re‐treatment in cases of eradication failure. Aim : To perform drug sensitivity testing for metronidazole in 92 H. pylori ‐positive patients who had failed eradication treatment with first‐line triple therapy, consisting of a proton pump inhibitor, amoxicillin and clarithromycin, and were administered metronidazole‐containing second‐line therapy. Methods : Second‐line eradication therapy, consisting of rabeprazole (20 mg b.d.), amoxicillin (750 mg b.d.) and metronidazole (250 mg b.d.), was administered for 1 week and the eradication rates and influence of metronidazole resistance were determined. Results : The eradication rates for rabeprazole–amoxicillin–metronidazole were 88% (81/92) using intention‐to‐treat analysis and 91% (81/89) using per protocol analysis. The eradication rates were 97% (61/63) for metronidazole‐sensitive strains and 82% (18/22) for metronidazole‐resistant strains. Conclusions : As second‐line H. pylori eradication treatment in Japan, rabeprazole–amoxicillin–metronidazole triple therapy is effective, even with metronidazole‐resistant strains.