Efficacy of Esomeprazole-Amoxicillin rescue therapy for H. pylori infection

Summaries 2 min 134

Font Size

Created On: 18/02/2025

To compare the safety and efficacy of high-dose Esomeprazole-Amoxicillin (high-dose dual therapy [HDDT]) regimen compared to Furazolidone-based quadruple therapy (FBQT) in Helicobacter pylori (H. pylori) infected patients who did not respond to prior therapies.

See All

Key take away

Non-responders to H. pylori treatment can benefit from high-dose Esomeprazole when used along with Amoxicillin therapy, which offers high eradication rates and fewer side effects.

Background

Method

Two hundred and nine individuals with H. pylori infection, who experienced treatment failure were assigned to either of the two groups- high-dose Esomeprazole-Amoxicillin regimen or FBQT groups. All patients adhered to the 14-day treatment plan and the success rates of H. pylori eradication, along with the safety were assessed 4 weeks after completion.

Result

In the intention-to-treat (ITT) and per-protocol (PP) analysis, the eradication rates did not vary significantly amongst the groups after 14 days, as shown in Table 1:

High-dose Esomeprazole-Amoxicillin regimen demonstrated suggestively fewer adverse reactions (9.1% in ITT and 9.2% in PP) than FBQT (58.6% in ITT and 59.8% in PP). Eradication rates were influenced by factors like interval time, alkaline phosphatase, and serum creatinine levels.

The area beneath the receiver operating characteristic curve (ROC) for the time interval between the FBQT and high-dose Esomeprazole-Amoxicillin regimen groups in relation to eradication success was 0.622 and 0.578, respectively. Optimal rescue therapy intervals were 6 months for FBQT and 1 year for high-dose Esomeprazole-Amoxicillin.

Conclusion

High-dose Esomeprazole and Amoxicillin proved effective and safe in treating H. pylori infection, offering the added advantages of fewer side effects and better medication adherence.