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Double‐Dose, New‐Generation Proton Pump Inhibitors Do Not Improve Helicobacter pylori Eradication Rate
Author(s) -
Choi Hyo Sun,
Park Dong Il,
Hwang Sang Jun,
Park Jung Sik,
Kim Hong Joo,
Cho Yong Kyun,
Sohn Chong Il,
Jeon Woo Kyu,
Kim Byung Ik
Publication year - 2007
Publication title -
helicobacter
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.206
H-Index - 79
eISSN - 1523-5378
pISSN - 1083-4389
DOI - 10.1111/j.1523-5378.2007.00556.x
Subject(s) - omeprazole , esomeprazole , pantoprazole , rabeprazole , helicobacter pylori , amoxicillin , medicine , proton pump inhibitor , gastroenterology , clarithromycin , tolerability , antibiotics , adverse effect , microbiology and biotechnology , biology
Background: Up to present, omeprazole plus two antibiotics are used for Helicobacter pylori eradication therapy . Few studies have compared double‐dose new‐generation, proton pump inhibitors (PPI) with omeprazole. Therefore, we conducted a randomized, prospective study to evaluate differences in H. pylori eradication rates by PPI type. Material and Methods: Between January 2006 and December 2006, 576 consecutive patients with proven H. pylori infection were enrolled prospectively. Four different PPIs [omeprazole 20 mg b.i.d. (old generation), or pantoprazole 40 mg b.i.d., rabeprazole 20 mg b.i.d., or esomeprazole 40 mg b.i.d. (new generation)] were added to clarithromycin (500 mg b.i.d.) and amoxicillin (1 g b.i.d.) for 1 week. Results: By intention‐to‐treat analysis, no difference was found between the eradication rates of these four PPIs: 64.9% (omeprazole, n = 148), 69.3% (pantoprazole, n = 140), 69.3% (rabeprazole, n = 140), and 72.9% (esomoprazole, n = 148). When eradication rates were analyzed according to whether patients had an ulcer or not on a per‐protocol basis, no difference was found between the eradication rates of the four PPIs. However, side‐effects were more common in the esomeprazole‐based triple therapy group than in the other groups ( p < .05). Conclusions: No convincing evidence was obtained that double‐dose new‐generation PPIs have better H. pylori eradication rates and tolerability than omeprazole.