High‐dose rabeprazole–amoxicillin dual therapy and rabeprazole triple therapy with amoxicillin and levofloxacin for 2 weeks as first and second line rescue therapies for <i><scp>H</scp>elicobacter pylori</i> treatment failures

Goh, Khean Lee; Manikam, Jeeta; Qua, Choon‐Seng

doi:10.1111/j.1365-2036.2012.05054.x

Cited by 28 publications

(33 citation statements)

References 36 publications

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“…24 Goh et al reported that the eradication rate of high-dose rabeprazole-amoxicillin dual therapy (amoxicillin 3000 mg, rabeprazole 60 mg for two weeks) was 71.4% as rescue therapy. 25 Attumi et al performed the eradication rate of high-dose dexlansoprazole and amoxicillin dual therapy (amoxicillin 2000 mg, dexlansoprazole 240 mg for two weeks) was 53.8%. 26 The eradication rates of our 10 day and 14 day rifabutin, amoxicillin and PPI regimens were clearly superior to previous high-dose PPI-amoxicillin, thus it is probable that rifabutin contributes an additive effect or synergistic effect in our rifabutin, amoxicillin and PPI regimens.…”

Section: Discussionmentioning

confidence: 99%

Rifabutin-based 10-day and 14-day triple therapy as a third-line and fourth-line regimen forHelicobacter pylorieradication: A pilot study

Mori

Suzuki

Matsuzaki

et al. 2015

United European Gastroenterology Journal

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Background and aim: This prospective randomized study was designed to assess the efficacy of 10-day and 14-day rifabutinbased triple therapy as a third-or fourth-line rescue therapy. Methods: Patients who failed first-and second-line eradication therapy were enrolled. H. pylori was isolated from gastric biopsy specimens and the rpoB mutation status, a factor of resistance to rifamycins, and minimum inhibitory concentrations (MICs) of rifabutin and amoxicillin were determined. Enrolled patients were randomly assigned to receive 10-day or 14-day eradication therapy with esomeprazole (20 mg, 4 times a day (q.i.d.)), amoxicillin (500 mg, q.i.d.), and rifabutin (300 mg, once a day (q.d.s.)). Poor compliance was defined as intake of <80% of study drugs. Successful H. pylori eradication was confirmed using a [13C] urea breath test or a stool antigen test, 12 weeks after the end of therapy. Results: Twelve patients were assigned to the 10-day group, and 17, to the 14-day group. Intention-to-treat and per-protocol analyses of eradication rates were 83.3% and 81.8% for the 10-day group and 94.1% and 91.7% for the 14-day group, respectively. All patients with rpoB mutation-positive strains (n ¼ 3) showed successful eradication, irrespective of the regimen received. Therapy was stopped due to adverse events in 8.3% and 29.3% of patients in the 10-day and 14-day groups, respectively. Conclusion: Both the 10-day and 14-day therapies were effective as rescue regimens. In particular, the 14-day therapy resulted in successful eradication in over 90% of patients, but the 10-day treatment may be enough to obtain a successful eradication rate, considering the tolerability of therapy.

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Section: Discussionmentioning

confidence: 99%

Rifabutin-based 10-day and 14-day triple therapy as a third-line and fourth-line regimen forHelicobacter pylorieradication: A pilot study

Mori

Suzuki

Matsuzaki

et al. 2015

United European Gastroenterology Journal

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“…Other fluoroquinolones such as moxifloxacin may also be useful second-line agents. One study showed a second-line eradication rate of 95.0% using 14-day moxifloxacin-based therapy and 78.9% for a 7-day regimen [40]. Tetracycline despite its history of very low resistance levels, unfortunately was not shown to be effective with eradication rates of 46.6% when given as a second-line regime with PPI and amoxicillin [41].…”

Section: Rescue Therapiesmentioning

confidence: 99%

Treatment of Helicobacter pylori infection 2012

et al. 2012

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Helicobacter pylori resistance rates to antibiotics vary in different countries and even in different regions of the same country. Choice of treatment is strongly dependent on antibiotic resistance rates. In some countries, triple therapy with a proton-pump inhibitor, amoxicillin, and clarithromycin is still the best option, but eradication results fall short of what would be desired (90-95%) in countries with clarithromycin resistance >20%, bismuth-containing quadruple therapy, or nonbismuth sequential or concomitant therapies may then be the preferred option. Newer antibiotic regimens are awaited. Vaccination would be the best option, especially for developing countries, but little progress has been made in designing a vaccine.A considerable amount of work has been conducted over the last year assessing many issues around Helicobacter pylori eradication therapy. These focussed primarily on assessing the efficacy of current standard triple therapy and exploring new first-line treatments. There was also progress in investigating antibiotic resistance rates, and the rescue therapies required to deal with ensuing treatment failures. There has also been an evolution in the use of adjunctive therapies. This article will address the published literature over the last year pertaining to these topics. Triple TherapyNumerous studies over the last year have assessed the efficacy of standard triple therapy with amoxicillin, clarithromycin, and a proton-pump inhibitor for the eradication of H. pylori, which have been perceived to be in decline in recent years. One such study looked at cure rates reported in all published literature from Spain between 1997 and 2008 and found that while cure rates have in fact been stable over that period, they remain inadequate with a mean cure rate of 80% by intention-to-treat and 83% by per-protocol [1]. Similar results were obtained from a multicenter study in Japan that revealed an eradication rate of 80.7% with an incidence of adverse drug reactions of 4.4% [2]. Other studies have looked at whether the efficacy of triple therapy can be improved by prolonging the course of therapy. In China, a study of shorter regimens showed eradication rates of 76, 89, and 91% for 3-day, 5-day, and 7-day regimens, respectively [3]. Increasing efficacy by prolongation of therapy was also noted in Greek patients, with eradication rates of 74.5% for 7 days, 80.6% for 10 days, and 90.2% for 14 days of therapy [4]. Another study showed that efficacy could be maintained when lower doses of medications were given, which reduced costs and side effects with cure rates of 77.2% for 10 mg rabeprazole, 500 mg amoxicillin, and 250 mg clarithromycin vs 78.9% for the standard 20 mg, 1 g, and 500 mg doses of these drugs [5].Regardless of the type of therapy used, study from Canada showed widespread failure to comply with test and treat in up to 10% of cases and a failure to confirm eradication in 32% [6]. This illustrates that efficacious first-line therapy will always depend on adherence to guidelines by phy...

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“…Due to the high metronidazole resistance rate in Malaysia [21], [22], metronidazole is not recommended. In cases where the therapy failed, two consecutive rescue regimens are used [23], [24]. The first line rescue regimen consists of rabeprazole 20 mg three times daily and amoxicillin 1 g three times daily for two weeks [23].…”

Section: Introductionmentioning

confidence: 99%

“…In cases where the therapy failed, two consecutive rescue regimens are used [23], [24]. The first line rescue regimen consists of rabeprazole 20 mg three times daily and amoxicillin 1 g three times daily for two weeks [23]. Rabeprazole is less susceptible to the influence of genetic polymorphisms for CYP2C19.…”

Section: Introductionmentioning

confidence: 99%

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Functional and Molecular Surveillance of Helicobacter pylori Antibiotic Resistance in Kuala Lumpur

et al. 2014

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Background Helicobacter pylori is the etiological agent for diseases ranging from chronic gastritis and peptic ulcer disease to gastric adenocarcinoma and primary gastric B-cell lymphoma. Emergence of resistance to antibiotics possesses a challenge to the effort to eradicate H. pylori using conventional antibiotic-based therapies. The molecular mechanisms that contribute to the resistance of these strains have yet to be identified and are important for understanding the evolutional pattern and selective pressure imposed by the environment.Methods and Findings H. pylori was isolated from 102 patients diagnosed with gastrointestinal diseases, who underwent endoscopy at University Malaya Medical Centre (UMMC). The isolates were tested for their susceptibility on eleven antibiotics using Etest. Based on susceptibility test, 32.3% of the isolates were found to have primary metronidazole resistance; followed by clarithromycin (6.8%) and fluoroquinolones (6.8%). To further investigate the resistant strains, mutational patterns of gene rdxA, frxA, gyrA, gyrB, and 23S rRNA were studied. Consistent with the previous reports, metronidazole resistance was prevalent in the local population. However, clarithromycin, fluoroquinolone and multi-drug resistance were shown to be emerging. Molecular patterns correlated well with phenotypic data. Interestingly, multi-drug resistant (MDR) strains were found to be associated with higher minimum inhibitory concentration (MIC) than their single-drug resistant (SDR) counterparts. Most importantly, clarithromycin-resistant strains were suggested to have a higher incidence for developing multi-drug resistance.ConclusionData from this study highlighted the urgency to monitor closely the prevalence of antibiotic resistance in the Malaysian population; especially that of clarithromycin and multi-drug resistance. Further study is needed to understand the molecular association between clarithromycin resistance and multi-drug resistance in H. pylori. The report serves a reminder that a strict antibiotic usage policy is needed in Malaysia and other developing countries (especially those where H. pylori prevalence remained high).

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High‐dose rabeprazole–amoxicillin dual therapy and rabeprazole triple therapy with amoxicillin and levofloxacin for 2 weeks as first and second line rescue therapies for Helicobacter pylori treatment failures

Abstract: SUMMARYBackground H. pylori eradication failures are difficult to treat and rescue therapies often consist of complex treatment regimens.

Cited by 28 publications

References 36 publications

Rifabutin-based 10-day and 14-day triple therapy as a third-line and fourth-line regimen forHelicobacter pylorieradication: A pilot study

Rifabutin-based 10-day and 14-day triple therapy as a third-line and fourth-line regimen forHelicobacter pylorieradication: A pilot study

Treatment of Helicobacter pylori infection 2012

Functional and Molecular Surveillance of Helicobacter pylori Antibiotic Resistance in Kuala Lumpur

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