A 10-day triple therapy is somewhat more effective than 7-day treatment for curing Helicobacter pylori infection.
Recent studies suggest that rabeprazolea proton pump inhibitor with fast onset of acid inhibition raise the efficacy of 7-day therapies to levels obtained with a 10-day treatment.
Dr Xavier Calvet and colleagues from Spain compared the efficacy of 7- and 10-day rabeprazole-based triple therapy for H pylori eradication.
The research team randomized 458 patients to 7 or 10 days of triple therapy, including rabeprazole 20 mg, clarithromycin 500 mg, and amoxicillin 1 g, all twice a day.
|Intention to treat cure rates were 74% for 7-day vs 80% for 10-day therapy|
|American Journal of Gastroenterology|
The researchers evaluated cure rates by urea breath test.
The team gave 237 patients 7-day treatment and 221 patients received 10-day therapy.
Groups were comparable in terms of demographic variables.
The researchers found that intention to treat cure rates were 74% for 7-day and 80% for 10-day therapy.
The team noted that per-protocol cure rates were 82% and 89%, for 7-day and 10-day therapy, respectively.
Cure rates were similar in peptic ulcer patients but in subjects without ulcer they were lower for 7-day therapy at 66% vs 77% by intention to treat.
The team also observed that the cure rates in subjects without ulcer in the per-protocol analysis were 73% versus 91%.
Side effects and compliance in the 2 groups were comparable.
Dr Calvet's team concludes, “The 7- and 10-day triple therapies seem equally efficient in peptic ulcer patients.”
“In contrast, 7-day therapy is significantly less effective in nonulcer dyspepsia patients.”
“A 10-day therapy, therefore, seems preferable when treating nonulcer patients.”