ASSESSMENT OF A NEW TRIPLE AGENT REGIMEN FOR THE ERADICATION OF HELICOBACTER-PYLORI AND THE NATURE OF HELICOBACTER-PYLORI RESISTANCE TO THIS THERAPY IN JAPAN

Background. Multiple regimens for the eradication of Helicobacter pylo ri have been tested, but the best therapy has not been determined yet. To determine the efficacy of a new triple agent regimen using a combi nation of lansoprazole, amoxicillin, and clarithromycin against Helico bacter pylori (H. pylori), and to examine H. pylori resistance to this therapy in ineffective cases. Methods. We studied a total of 71 patie nts infected with H. pylori who had gastric ulcer (n = 37) or duodenal ulcer (n = 34) as confirmed by endoscopy. Patients received 1500 mg a moxicillin, 400 mg clarithromycin and 30 mg lansoprazole for 2 weeks f ollowed by 30 mg lansoprazole for 6 weeks in patients with gastric ulc er or for 4 weeks in those with duodenal ulcer. Endoscopic examination was performed before treatment and at 1 month, 2 months, and 5 months after initiating treatment to check the status of ulceration and H. p ylori infection. Results. The eradication rate of H. pylori was 92% (C I, 83-100%) in the gastric ulcer group and 94% (CI, 86-100%) in the du odenal ulcer group at 5 months, as determined by per-protocol analysis . Resistance to clarithromycin was present in 1 of 71 (1%) patients be fore treatment and in 2 of 5 (40%) patients after treatment. No resist ance to amoxicillin and lansoprazole was found in patients before or a fter treatment. The resistance to clarithromycin changed during the ob servation period. Conclusions. The new triple agent regimen was effect ive against H. pylori. Resistance to clarithromycin may not be permane nt and it might be one of the risk factors which affect the efficacy o f a clarithromycin-based therapy.