Efficacy of Goshuyuto/Rabeprazole for Refractory H pylori

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The patients' urea breath tests were positive after primary triplet therapy with amoxicillin, clarithromycin, and rabeprazole or vonoprazan.
The patients' urea breath tests were positive after primary triplet therapy with amoxicillin, clarithromycin, and rabeprazole or vonoprazan.

HealthDay News — Refractory Helicobacter pylori (HP) infection can be successfully treated with goshuyuto and rabeprazole, according to a case report published in the Journal of Digestive Diseases.

Yutaka Nagata, MD, PhD, from Suwa Central Hospital in Nagano, Japan, and colleagues describe 3 cases of refractory HP infection after vonoprazan-based triple therapy.

All the cases had HP infection with chronic gastritis, and were treated with eradication therapy, according to the researchers. The patients' urea breath tests were positive after primary triplet therapy with amoxicillin, clarithromycin, and rabeprazole (case 1) or vonoprazan (case 2, 3). 

Their urea breath tests were still positive after subsequently receiving secondary eradication therapy with amoxicillin, metronidazole, and vonoprazan (case 1, 2) or rabeprazole (case 3). Their urea breath test became negative after Kampo eradication therapy consisting of goshuyuto 2.5 g 3-times daily plus rabeprazole 10 mg twice daily for 2 days.

"Goshuyuto treatment is worth trying as another therapeutic option," the authors write.

Reference

Nagata Y, Nagasaka K, Koyama S, et al. Successful eradication of Helicobacter pylori with a herbal medicine, goshuyuto (Wu Zhu Yu Tang), plus rabeprazole after failure of triplet therapy with vonoprazan: a report of three cases [published online August 28, 2017] J Dig Dis. doi: 10.1111/1751-2980.12537.

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