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Dual therapy for third-line Helicobacter pylori eradication and urea breath test prediction.
- Source :
-
World journal of gastroenterology [World J Gastroenterol] 2012 Jun 07; Vol. 18 (21), pp. 2735-8. - Publication Year :
- 2012
-
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.
- Subjects :
- Adult
Aged
Anti-Bacterial Agents administration & dosage
Anti-Ulcer Agents administration & dosage
Female
Humans
Male
Microbial Sensitivity Tests
Middle Aged
Predictive Value of Tests
Prospective Studies
Rabeprazole
Sensitivity and Specificity
2-Pyridinylmethylsulfinylbenzimidazoles administration & dosage
Amoxicillin administration & dosage
Breath Tests methods
Drug Therapy, Combination methods
Helicobacter Infections diagnosis
Helicobacter Infections drug therapy
Helicobacter pylori drug effects
Urea analysis
Subjects
Details
- Language :
- English
- ISSN :
- 2219-2840
- Volume :
- 18
- Issue :
- 21
- Database :
- MEDLINE
- Journal :
- World journal of gastroenterology
- Publication Type :
- Report
- Accession number :
- 22690086
- Full Text :
- https://doi.org/10.3748/wjg.v18.i21.2735