Korean J Gastroenterol.  2008 May;51(5):280-284.

Effectiveness of 10 Day-sequential Therapy for Helicobacter pylori Eradication in Korea

• Choi WH
• Park DI
• Oh SJ
• Baek YH
• Hong CH
• Hong EJ
• Song MJ
• Park SK
• Park JH
• Kim HJ
• Cho YK
• Sohn CI
• Jeon WK
• Kim BI

Abstract

BACKGROUND/AIMS: Antibiotic resistance and poor compliance are the main causes of Helicobacter pylori (H. pylori) eradication failure. Proton pump inhibitor (PPI)-based triple therapy is the most preferred regimen in clinical practice. However, a critical fall in the H. pylori eradication rate has been observed in the recent years. A novel 10 day-sequential therapy consists of five days of dual therapy followed by five days of triple therapy regimen has recently been described. We aimed to evaluate whether 10 day-sequential therapy eradicated H. pylori infection better than the PPI-based triple therapy in Korea.
METHODS
158 patients with proven H. pylori infection were randomized to receive either 10 day-sequential therapy (20 mg of omeprazole, 1.0 g of amoxicillin, each administered twice daily for the first 5 days, followed by 20 mg of omeprazole, 500 mg of clarithromycin, 500 mg of metronidazole, each administered twice daily for the remaining 5 days) or PPI-based triple therapy (20 mg of omeprazole, 1.0 g of amoxicillin, 500 mg of clarithromycin, each administered twice daily for 1 week). Outcome of eradication therapy was assessed 8 weeks after the cessation of treatment.
RESULTS
Eradication rates of 10 day-sequential therapy and PPI-based triple therapy were 77.9% (60/77) and 71.6% (58/81) by intention to treat analysis, respectively (p=0.361). By per protocol analysis, eradication rates of 10 day-sequential therapy and triple therapy were 85.7% (60/70) and 76.6% (58/76), respectively (p=0.150). There were no significant differences in adverse event rates and treatment compliance between two groups.
CONCLUSIONS
The 10 day-sequential therapy regimen failed to achieve significantly higher eradication rates than PPI-based triple therapy.

Keyword

Helicobacter pylori; Sequential therapy; Eradication rate

MeSH Terms

Adult
Amoxicillin/administration & dosage
Anti-Bacterial Agents/*administration & dosage
Anti-Ulcer Agents/administration & dosage
Data Interpretation, Statistical
Drug Therapy, Combination
Female
Helicobacter Infections/*drug therapy/microbiology
*Helicobacter pylori
Humans
Korea
Male
Metronidazole/administration & dosage
Middle Aged
Omeprazole/administration & dosage
Time Factors
Treatment Outcome