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    
Abstract/OtherAbstract:
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.
Authors:
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.
Affiliation:
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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