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Rabeprazole/ Levofloxacin/Rifabutin Therapy Equally Effective as Quadruple Therapy in Second-Line Treatment of Helicobacter Pylori
A DGReview of :"Randomized controlled study of rabeprazole, levofloxacin and rifabutin triple therapy vs. quadruple therapy as second-line treatment for Helicobacter pylori infection"
Alimentary Pharmacology & Therapeutics
03/18/2003
By David Ball
Rabeprazole, levofloxacin and rifabutin-based triple therapy is just as effective as quadruple therapy, as second-line treatment for Helicobacter pylori infection, say Chinese researchers.
The researchers, led by W.M.Wong and colleagues at the Department of Medicine, University of Hong Kong, Queen Mary Hospital, tested the efficacy of the two regimens in 109 patients who had all failed H. pylori eradication earlier. The patients were randomised into two groups.
The triple therapy group received rabeprazole, 20 mg twice daily; rifabutin, 300 mg once daily; and levofloxacin, 500 mg once daily, for seven days.
Those in the quadruple therapy group were given rabeprazole, 20 mg twice daily; metronidazole, 400 mg three times daily; bismuth subcitrate, 120 mg four times a day; and tetracycline, 500 mg four times daily, for seven days.
Endoscopy and culture were performed before treatment.
Significantly higher resistance rates were found in subjects with previous exposure compared with those with no previous exposure: clarithromycin, 79 vs. 21% ( P < 0.001) and metronidazole, 89 vs. 40% (P < 0.001).
In the triple therapy group, the intention-to-treat and per protocol eradication rates were 91%/91% and for the quadruple therapy subjects they were 91%/92%.
The eradication rate for patients in the triple therapy group with double resistance to metronidazole and clarithromycin was 85%, 17 of 20 subjects.
In the quadruple therapy group the eradication rate for those with double resistance to metronidazole and clarithromycin was 87%,13 of 15 subjects.
Both regimens showed a compliance rate greater than 95 %.
Aliment Pharmacol Ther 2003 Feb;17:4:553-60.
"Randomized controlled study of rabeprazole, levofloxacin and rifabutin triple therapy vs. quadruple therapy as second-line treatment for Helicobacter pylori infection"
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