Repeated Combination Therapy with Alternative Antibiotics Enhances Eradication Rate of <I>Helicobacter pylori</I>
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We have studied the effectiveness of two regimens { Regimen A : Lansoprazole (LPZ) 30 mg, metronidazole (MNZ) 500 mg and amoxicillin (AMPC) 1500 mg for one week; Regimen B : LPZ 30 mg, MNZ 500 mg and clarithromycin (CAM) 400 mg for one week } for the treatment of <I>Helicobacter pylori</I>. We also studied the effectiveness of re-treatment with alternative regimens where an initial treatment failed. The study was conducted as a randomized controlled prospective trial using 147 patients infected with <I>H. pylori</I>. The cure rates of Regimens A and B were 87.0% (67/77) and 85.7% (60/70), respectively, and the accumulated success rates were 97.3% (71/73) and 98.5% (66/67) . The accumulated success rates were significantly higher than the cure rates obtained by the initial treatments. Of the 147 clinical isolates, 0 %, 6.1%, and 2.7% had primary resistance to AMPC, CAM and MNZ, respectively, while 0 %, 60%, and 100% developed secondary resistance to AMPC, CAM and MNZ, respectively. The cure rate was 100% (2/2) for strains that were sensitive to CAM but resistant to MNZ; and 33.3% (1/3) for strains that were resistant to CAM but sensitive to MNZ. The presence of resistance to CAM, but not MNZ, was directly related to the efficacy of treatment. From these results, we suggest that the eradication rate will be approximately 100% after treatment with the combination of LPZ 30 mg, MNZ 500 mg and either AMPC 1500mg or CAM 400 mg for one week.
- 昭和大学・昭和医学会の論文
昭和大学・昭和医学会 | 論文
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