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Eradication rates for Helicobacter pylori infection using a triple therapy with a proton-pump inhibitor (PPI) and clarithromycin vary considerably in different countries. In some countries, bacterial resistance to this treatment appears to be increasing. When initial treatment fails, the optimal rescue therapy is often complex and unclear.
Investigators in Malaysia conducted a sequential study using rabeprazole-based therapies in patients who had failed a 1-week triple therapy with a PPI and clarithromycin. After confirmation of persistent infection with a breath test, 149 consecutive patients were treated with 20 mg of rabeprazole and 1 g of amoxicillin three times daily for 2 weeks. If a second breath test showed persistent infection, pati…