Korean J Helicobacter Up Gastrointest Res.  2023 Dec;23(4):277-282. 10.7704/kjhugr.2023.0042.

Comparison of Helicobacter pylori Eradication Rates Using Standard Triple Therapy and Sequential Therapy

• Kim Y
• Ahn JY
• Jung HY
• Noh JH
• Na HK
• Jung KW
• Lee JH
• Kim DH
• Choi KD
• Song HJ
• Lee GH

• KMID: 2548716
• DOI: http://doi.org/10.7704/kjhugr.2023.0042

Abstract

Objectives
The incidence of treatment failures following standard triple therapy (STT) for Helicobacter pylori eradication (HPE) has reached an unacceptable level. Sequential therapy (SQ) has emerged as a promising approach to counteract the escalation of antibiotic resistance. In this study, we used a chronological cohort dataset to conduct a comparative analysis of the eradication rates, compliance, and adverse events associated with the 7-day STT and SQ.
Methods
A total of 789 patients underwent HPE treatment at Asan Medical Center between July 2013 and August 2017. Among them, 378 received a 7-day STT and 411 received a 10-day SQ. Baseline clinical data and treatment parameters were compared between the two treatment groups.
Results
SQ demonstrated an eradication rate of 84.7% (348/411), which was superior to that of the 7-day STT (74.1%; p<0.001). The incidence of adverse events was also higher in the SQ group than in the STT group (17.5% vs. 11.1%; p=0.01). Nonetheless, treatment compliance was not significantly different between the groups (98.1% [SQ] vs. 96.8% [STT]; p=0.38). Among the patients undergoing second-line eradication, the SQ group displayed a lower eradication rate than the STT group (77.8% vs. 92.4%; p=0.028). Notably, the overall eradication rate did not differ significantly between the two groups (98.3% [STT] vs. 97.4% [SQ]; p=0.56).
Conclusions
SQ exhibited superior efficacy compared with the 7-day STT as a first-line H. pylori treatment. Thus, SQ holds potential to serve as the replacement for the 7-day STT in treatment-naïve patients.

Keyword

Helicobacter pylori; Eradication; Antibiotics; Standard triple therapy; Sequential therapy