Effect of genotypic differences in CYP2C19 on cure rates for Helicobacter pylori infection by triple therapy with a proton pump inhibitor, amoxicillin, and clarithromycin

• DOI: 10.1067/mcp.2001.113959
• Publication Date: 2002-07-25T04:19:27Z
• Authors: T Furuta
• Keywords: Lansoprazole

Background Proton pump inhibitors such as omeprazole and lansoprazole are mainly metabolized by CYP2C19 in the liver. The therapeutic effects of proton assumed to depend on genotype status. Objective We investigated whether status was related eradication rates H pylori triple inhibitor–clarithromycin–amoxicillin (INN, amoxicilline) therapy attempted establish a strategy for treatment after failure eradicate pylori. Methods A total 261 patients infected with completed initial 20 mg or 30 twice day, 200 clarithromycin three times 500 amoxicillin day 1 week. genotypes were determined polymerase chain reaction–restriction fragment length polymorphism analysis. Patients without retreated four daily 2 weeks. Results Eradication 72.7% (95% confidence interval, 64.4%-81.8%), 92.1% (confidence 86.4%-97.3%), 97.8% 88.5%-99.9%) homozygous extensive, heterozygous poor metabolizer groups, respectively. Thirty-four 35 had an extensive CYP2C19. Nineteen those clarithromycin-resistant strains However, there no amoxicillin-resistant Re-treatment infection dual high-dose lansoprazole-amoxicillin succeeded 31 Conclusion majority but successfully re-treated high doses antibiotic which sensitive, amoxicillin, even when Clinical Pharmacology & Therapeutics (2001) 69, 158–168; doi: 10.1067/mcp.2001.113959