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- Title
Comparison of Lafutidine and Rabeprazole in 7-day Second-line Amoxicillin- and Metronidazole-Containing Triple Therapy for Helicobacter pylori: A Pilot Study.
- Authors
Kudo, Takahiko; Fujinami, Haruka; Ando, Takayuki; Nishikawa, Jun; Ogawa, Kohei; Hosokawa, Ayumu; Orihara, Tadahiro; Murakami, Jun; Takahara, Terumi; Sugiyama, Toshiro
- Abstract
Background: Lafutidine is an H2-receptor antagonist with gastroprotective action through capsaicin-sensitive afferent neurons and relatively inexpensive compare to proton-pump inhibitors (PPIs). A 7-day course of PPIs-amoxicillin-metronidazole is recommended as standard second-line Helicobacter pylori therapy and is covered by national health insurance in Japan. The aim of this study was to determine the efficacy and safety of second-line eradication using the H2-receptor antagonist lafutidine as a substitute for a PPI. Materials and Methods: Fifty-two patients who failed in first-line eradication using PPI-amoxicillin-clarithromycin were randomly assigned to a 7-day course of rabeprazole at 10 mg b.i.d., amoxicillin at 750 mg b.i.d., and metronidazole at 250 mg b.i.d. (RPZ-AM) or a 7-day course of lafutidine at 10 mg t.i.d., amoxicillin at 750 mg b.i.d., and metronidazole at 250 mg b.i.d. (LFT-AM) as second-line therapy. Eradication was assessed by the 13C urea breath test. A drug susceptibility test was performed before the second-line therapy. Results: Prior to second-line H. pylori eradication, the rate of resistance to clarithromycin was 86.5% and the rate of resistance to metronidazole was 3.8%. The eradication rates for both LFT-AM and RPZ-AM groups were 96% (95%CI = 88.6-100%). There were no severe adverse events in either group. Conclusions: Lafutidine plus metronidazole-amoxicillin as second-line therapy provided a high eradication rate and safe treatment similar to a PPI-based regimen. Lafutidine-based eradication therapy is therefore considered to be a promising alternative and is also expected to reduce health care costs in H. pylori eradication.
- Subjects
JAPAN; AMOXICILLIN; METRONIDAZOLE; TREATMENT of helicobacter pylori infections; PILOT projects; MICROBIAL sensitivity tests; PROTON pump inhibitors; NATIONAL health insurance
- Publication
Helicobacter, 2012, Vol 17, Issue 4, p277
- ISSN
1083-4389
- Publication type
Article
- DOI
10.1111/j.1523-5378.2012.00943.x