Rabeprazole‐amoxicillin dual therapy as first‐line treatment for H pylori eradication in special patients: A retrospective, real‐life study

BACKGROUND: The currently recommended quadruple regimens for Helicobacter pylori infection might not be appropriate for every patient, especially in elderly patients or those with multiple comorbidities. OBJECTIVE: To evaluate the efficacy and safety of rabeprazole‐amoxicillin dual therapy in H pylori‐positive elderly patients or those with multiple comorbidities. METHODS: From November 2013 to May 2017, the clinical data of H pylori‐positive patients ≥60 years old or with multiple comorbidities were collected and reviewed. All patients were given rabeprazole 10 mg three times a day and amoxicillin 1000 mg thrice a day (RA dual therapy) for 14 days as first‐line treatment. H pylori eradication was evaluated by (13)C‐urea breath test 6 weeks after treatment. Adverse effects were recorded. RESULTS: A total of 198 patients were enrolled, including 116 elderly patients and 82 patients with multiple comorbidities. Successful eradication was achieved in 90.9% (180/198, 95% CI: 86.1%‐94.2%) patients. Adverse effects, which were mainly mild (referring to skin rash, abdominal pain, and diarrhea), occurred in 22 patients (22/198, 11.1%) and resolved spontaneously. CONCLUSION: Dual therapy composed of rabeprazole and amoxicillin as a first‐line treatment appears to be effective and safe for H pylori infection in elderly patients or those with multiple comorbidities. Additional studies are needed to optimize the regimen.