Efficacy and safety of faropenem in eradication therapy of Helicobacter pylori.
OBJECTIVE
While triple therapy with a proton pump inhibitor, amoxicillin, and clarithromycin is the standard therapy for Helicobacter pylori eradication, it is ineffective against clarithromycin-resistant strains. To seek a better regimen for eradication therapy, we assessed the sensitivity of clinical strains seen in Japan to faropenem and then evaluated the efficacy and safety of eradication therapy containing this antibiotic.


METHODS
Minimum inhibitory concentrations (MICs) of faropenem were determined in 78 Japanese clinical H. pylori isolates using the agar dilution method. H. pylori-positive patients were consecutively assigned to a 7-day eradication therapy protocol with LAF (lansoprazole 60 mg/day, amoxicillin 2000 mg/day, and faropenem 600 mg/day), and then to a 14-day protocol. The outcomes of the therapies were assessed by (13)C-urea breath tests.


RESULTS
All 78 strains showed MICs of faropenem that were equal to or less than 0.2 microg/mL. The eradication rates according to intention-to-treat analyses were 46.5% with the 7-day therapy (n = 43) and 62.5% with the 14-day therapy (n = 32). No special measures were required to treat the adverse events observed in approximately one-third of the patients.


CONCLUSIONS
Faropenem was found to have good antimicrobial action against H. pylori in vitro. The 14-day LAF therapy successfully eradicated H. pylori in about two-thirds of the patients although the incidence of adverse events was high.
Ogura
Keiji
K
Department of Gastroenterology, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Tokyo 113-8655, Japan. keiji-tky@umin.ac.jp
Mitsuno
Yuzo
Y
Maeda
Shin
S
Hirata
Yoshihiro
Y
Yanai
Ayako
A
Shibata
Wataru
W
Ohmae
Tomoya
T
Yoshida
Haruhiko
H
Kawabe
Takao
T
Omata
Masao
M
D000368:Aged; D000900:Anti-Bacterial Agents / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D005260:Female; D016481:Helicobacter Infections / Q000188:drug therapy*; D016480:Helicobacter pylori; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D047090:beta-Lactams / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*
D000900:Anti-Bacterial Agents; D047090:beta-Lactams; C107057:fropenem