Effect of additional ecabet sodium on conventional proton-pump inhibitor-based triple therapy for H-pylori (H-pylori) eradication in Korea

Abstract

Aims: The eradication rate of proton-pump inhibitor-based conventional triple therapy for H. pylori infection has decreased due to increasing antibiotics resistance. Ecabet sodium is known for bactericidal effect against H. pylori. It was reported that the supplement of ecabet sodium on conventional triple therapy met with good results in Asia, recently. Aim of this study was to ascertain the efficacy of additional ecabet sodium on conventional triple therapy for eradication of H. pylori in clinical practice. Methods: One hundred eleven patients (Group A) with proven H. pylori infection received ecabet sodium with triple therapy (20 mg of rabeprazole, 1 g of amoxicillin, 500 mg of clarithromycin and 1 g of ecabet sodium, twice daily for 7 days). One hundred ninety patients (Group B) received PPI- based triple therapy (same as above, except ecabet sodium). Eradication was evaluated 4 weeks later after completion of treatment by 13c- urea breath testing. The Side effects were also assessed. Results: The eradication rates were 74. 8% (83/111) in group A and 71.1% (135/190) in group B by intention-to-treat (p = 0.507), and 75.2% (82/109) in group A and 71.4% (132/ 185) in group B by per protocol (p = 0.500). There were no significant differences in the side effects between two treatment groups. Conclusions: The addition of ecabet sodium on conventional triple therapy is found to not effectively improve eradication rate of H. pylori in this study. The results imply ecabet sodium as additional agent could not overcome antibiotics resistance, which is the most important cause of failure of triple therapy.