5-day vs. 7-day triple therapy with rabeprazole, clarithromycin and amoxicillin for Helicobacter pylori eradication

Aim: To determine whether a 5-day regimen with rabeprazole, clarithromycin and amoxicillin (RCA) was as effective as a 7-day regimen. Methods: A total of 139 H. pylori-infected patients were randomized to rece ive either a 5-day or 7-day course of rabeprazole 10 mg b.d., clarithromyci n 400 mg b.d. and amoxicillin 750 mg b.d. Eradication was assessed by CLO t est, histology and C-13-urea breath test. Results: On the intention-to-treat basis, eradication rates were 66% (46 ou t of 70) and 84% (58 out of 69) for the 5- and 7-day regimens, respectively (P < 0.05). Using per protocol analysis, eradication rates were 70% (46 ou t of 66) and 91% (58 out of 64) for the 5- and 7-day regimens, respectively (P < 0.01). Adverse events, which were observed in 14 patients from each g roup, caused discontinuation of treatment in only two patients, resulting i n excellent compliance. Conclusions: Our 5-day regimen of RCA yielded inferior results, whereas the 7-day regimen achieved an eradication rate exceeding 90% on the per protoc ol basis. Therefore, treatment regimens of less than 7 days for proton pump inhibitor-clarithromycin-amoxicillin therapies cannot be recommended.