title: Efficacy of two rabeprazole/gatifloxacin-based triple therapies for Helicobacter pylori infection.
abstract: OBJECTIVE
  To evaluate the efficacy of two novel treatment regimens consisting of gatifloxacin (400 mg daily), amoxicillin (1 g twice daily), and rabeprazole 20 mg once (RAG20) or twice daily (RAG40) given for 7 days in the eradication of Helicobacter pylori.
  
  
  METHODS
  Eligible patients undergoing endoscopy and having a positive rapid urease assay for H. pylori were enrolled in this open-label trial. Gastric biopsies from a random cohort of patients were cultured for H. pylori and in vitro susceptibility to gatifloxacin and amoxicillin was performed using the E-test. Compliance and side-effects were evaluated by phone calls. (14)C-urea breath tests were performed a minimum of 4 weeks after therapy and 3 weeks after any acid suppressive therapy.
  
  
  RESULTS
  A total of 104 patients, 52 in each group (40 females and 64 males; mean age 45.7 years) were enrolled sequentially. Eradication occurred in 43 out of 52 patients in RAG20 group (both per-protocol and intention-to-treat analysis: 83%; 95% CI: 72-93%) and in 48 of 52 patients in the RAG40 group (both per-protocol and intention-to-treat analysis: 92%; 95% CI: 85-99%). Seven patients in the RAG40 group who had previously failed one or more treatment regimens for H. pylori were cured. No significant adverse effects were reported. All 50 recovered H. pylori strains were susceptible to amoxicillin and gatifloxacin in vitro.
  
  
  CONCLUSIONS
  A 7-day regimen of gatifloxacin-rabeprazole-amoxicillin is effective eradication therapy for H. pylori. The use of rabeprazole twice daily results in superior eradication rates including cases of failed primary therapy. This new regimen is simple, well-tolerated, and may lead to higher compliance and lower costs.
authors.affiliation: Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon. as08@aub.edu.lb
authors.forename: Ala I
authors.initials: AI
authors.lastname: Sharara
authors.forename: Hani F
authors.initials: HF
authors.lastname: Chaar
authors.forename: Eddy
authors.initials: E
authors.lastname: Racoubian
authors.forename: Oussayma
authors.initials: O
authors.lastname: Moukhachen
authors.forename: Kassem A
authors.initials: KA
authors.lastname: Barada
authors.forename: Fadi H
authors.initials: FH
authors.lastname: Mourad
authors.forename: George F
authors.initials: GF
authors.lastname: Araj
mesh_terms: D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D000328:Adult; D000658:Amoxicillin / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D000890:Anti-Infective Agents / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D000897:Anti-Ulcer Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001562:Benzimidazoles / Q000008:administration & dosage / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005260:Female; D024841:Fluoroquinolones / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D000077734:Gatifloxacin; D016481:Helicobacter Infections / Q000188:drug therapy* / Q000382:microbiology; D016480:Helicobacter pylori / Q000187:drug effects / Q000302:isolation & purification; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D009853:Omeprazole / Q000031:analogs & derivatives; D010437:Peptic Ulcer / Q000188:drug therapy / Q000382:microbiology; D064750:Rabeprazole; D016896:Treatment Outcome
chemical_list: D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D000890:Anti-Infective Agents; D000897:Anti-Ulcer Agents; D001562:Benzimidazoles; D024841:Fluoroquinolones; D064750:Rabeprazole; D000658:Amoxicillin; D009853:Omeprazole; D000077734:Gatifloxacin