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Randomized controlled study of rabeprazole, levofloxacin and rifabutin triple therapy vs. quadruple therapy as second‐line treatment for Helicobacter pylori infection

2003; Wiley; Volume: 17; Issue: 4 Linguagem: Inglês

10.1046/j.1365-2036.2003.01459.x

1365-2036

W. M. Wong, Qing Gu, King Hei Stanley Lam, F. M. Y. Fung, Koon Chun Lai, Wei Hu, Y. K. Yee, C. K. Chan, Harry Hua‐Xiang Xia, Man‐Fung Yuen, Bcy Wong,

Clostridium difficile and Clostridium perfringens research

Summary Aim : To test the efficacy of rabeprazole, levofloxacin and rifabutin triple therapy vs. quadruple therapy for the second‐line treatment of Helicobacter pylori infection. Methods : One hundred and nine patients who had failed previous H. pylori eradication were randomized to receive: (i) rabeprazole, 20 mg b.d., rifabutin, 300 mg once daily, and levofloxacin, 500 mg once daily, for 7 days (triple therapy); or (ii) rabeprazole, 20 mg b.d., metronidazole, 400 mg t.d.s., bismuth subcitrate, 120 mg q.d.s., and tetracycline, 500 mg q.d.s., for 7 days (quadruple therapy). Endoscopy and culture were performed before treatment. Results : The clarithromycin (79% vs. 21%, P < 0.001) and metronidazole (89% vs. 40%, P < 0.001) resistance rates were significantly higher in patients with previous exposure than in those with no previous exposure. The intention‐to‐treat and per protocol eradication rates were 91%/91% for the triple therapy group and 91%/92% for the quadruple therapy group. For patients with double resistance to metronidazole and clarithromycin, the eradication rates were 85% (17/20) in the triple therapy group and 87% (13/15) in the quadruple therapy group. Compliance was greater than 95% for both regimens. Conclusion : Rabeprazole, levofloxacin and rifabutin‐based triple therapy and quadruple therapy were equally effective as second‐line treatments for H. pylori infection.