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Postprandial dosing and higher Amoxicillin frequency may improve Vonoprazan-Amoxicillin dual therapy efficacy, particularly for H. pylori rescue treatments.
In a recent randomized controlled trial, administering Amoxicillin after meals and increasing its frequency significantly boosted the effectiveness of Vonoprazan-Amoxicillin (VA) therapy for H. pylori eradication when compared to other regimens. The impact of preprandial vs. postprandial Amoxicillin on the efficacy of VA-dual therapy for H. pylori hasn't been thoroughly explored. Therefore, a study published in “Helicobacter” investigated whether taking Amoxicillin before or after meals and at different frequencies affects the success of VA-dual therapy.
A total of 327 H. pylori-infected participants were randomly assigned to one of three groups for a 14-day treatment: Vonoprazan 20 mg twice daily + Amoxicillin 1000 mg three times daily before meals (BM-TID), 1000 mg three times daily after meals (AM-TID), or 750 mg four times daily after meals (AM-QID). Researchers compared eradication rates, adverse events, compliance, and antibiotic resistance among these groups. The eradication rates as per intention-to-treat (ITT), modified ITT (MITT), and per-protocol (PP) analysis for the BM-TID, AM-TID, and AM-QID have been described in Table 1 below.
AM-QID proved considerably more effective than BM-TID, although BM-TID and AM-TID were equally effective. No vital differences were noted in adverse events, compliance, or resistance rates among the groups. Amoxicillin taken four times daily after meals boosted the efficacy of VA-dual therapy for H. pylori, making it a stronger choice, especially for rescue therapy. Additionally, all tested regimens provided strong results as a first-line therapy.
Helicobacter
Vonoprazan–Amoxicillin Dual Therapy With Different Amoxicillin Administration Regimens for Helicobacter pylori Treatment: A Randomized Controlled Trial
Shuhan Qiu et al.
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