Document Detail

Ten-day sequential versus triple therapy for H. pylori eradication: A prospective, open-label, randomized trial.
MedLine Citation:
PMID:  22849546     Owner:  NLM     Status:  Publisher    
Introduction:  Increased resistance of Helicobacter pylori to antibiotics has increased the need to develop new first-line treatments for H. pylori. We have prospectively evaluated 10-day sequential versus conventional triple therapy in peptic ulcer patients. Methods:  One hundred fifty-nine patients with peptic ulcer diseases were prospectively randomized to receive 10 days of lansoprazole, amoxicillin, and clarithromycin (conventional triple therapy) or 5 days of lansoprazole and amoxicillin followed by 5 days of lansoprazole, clarithromycin, and metronidazole (sequential therapy). Post-treatment H. pylori status was determined by the (13) C-urea breath test. Eradication rates, antibiotic resistance rates by agar dilution method, drug compliance, and side effects were compared. Results:  The intention-to-treat eradication rates were 75.9% (95% CI: 66.5-85.3%, 60/79) in the sequential therapy group and 58.7% (95% CI 47.9-69.5%,47/80) in the conventional triple therapy group (P=0.01), while the per-protocol eradication rates were 86.8% (95% CI: 78.7-94.8%, 59/68) and 67.6% (95% CI 56.5-78.7%,46/68) (P=0.01), respectively. Compliance and side effects were similar in the two groups. Culture of H. pylori showed that 18.2% were resistant to clarithromycin, 41.9% to metronidazole. Dual resistance to both antibiotics was 9.6%. Conclusions:  Although 10-day sequential therapy yielded a higher H. pylori eradication rate than 10-day conventional triple therapy, the sequential therapy protocol did not result in a sufficiently satisfactory eradication rate. This might be related to the higher antibiotics resistance rate especially to dual resistance. More effective regimens are needed to overcome antibiotic resistance in Korea. © 2012 Journal of Gastroenterology and Hepatology Foundation and Blackwell Publishing Asia Pty Ltd.
Jun-Won Chung; Young Kul Jung; Yoon Jae Kim; Kwang Ahn Kwon; Jung Ho Kim; Jong Jun Lee; Ki Baik Hahm; Sun Mi Lee; Jin Yong Jeong; Sung-Cheol Yun
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-7-31
Journal Detail:
Title:  Journal of gastroenterology and hepatology     Volume:  -     ISSN:  1440-1746     ISO Abbreviation:  J. Gastroenterol. Hepatol.     Publication Date:  2012 Jul 
Date Detail:
Created Date:  2012-8-1     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8607909     Medline TA:  J Gastroenterol Hepatol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2012 Journal of Gastroenterology and Hepatology Foundation and Blackwell Publishing Asia Pty Ltd.
Department of Internal Medicine, Gachon Graduate School of Medicine, Gil Medical Center, Incheon, Korea Asan Institute for Life Sciences Clinical Epidemiology, University of Ulsan College of Medicine, Asan Medical Center.
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