High-dose PPI-Amoxicillin Dual Therapy for First-Line Helicobacter pylori Therapy

Background: The efficacy of treatment of Helicobacter pylori (H.pylori) infection has decreased because of increasing resistance to clarithromycin, metronidazole, and levofloxacin.Resistance to amoxicillin is generally low, and high intragastric pH increases the efficacy of amoxicillin, so we performed this study to assess the efficacy of a high-dose dual therapy in treatment-naive patients with H. pylori infection.Methods: a total of 89 patients with H. pylori infection were recruited in University Medical Center Ho Chi Minh city.All patients underwent endoscopy before treatment.Four to eight weeks after completing the course of therapy, H. pylori infection status was examined by C 13 -urea breath tests.Patients were received a high-dose dual therapy (rabeprazole 20 mg QID and amoxicillin 1000 mg QID for 14 days).Results: High-dose dual therapy achieved high efficacy of intention-to-treat (ITT) eradication rate, 84.3% (95% CI 75.6 -91.5%), and of per-protocol (PP) eradication rate 88.8% (95% CI 79.5 -93.9%).The adverse event rates were 29.2 %.Compliance rate was 96.6%. Conclusion: A 14day rabeprazole-and amoxicillin-containing high-dose dual therapy achieves a high eradication rate as first-line anti-H. pylori therapy.