title: High eradication rates of Helicobacter pylori with a new sequential treatment.
abstract: BACKGROUND
  Eradication rates of Helicobacter pylori with standard triple therapy are disappointing, and studies from several countries confirm this poor performance.
  
  
  OBJECTIVE
  To assess the eradication rate of a new sequential treatment regimen compared with conventional triple therapy for the eradication of H. pylori infection.
  
  
  METHODS
  One thousand and forty-nine dyspeptic patients were studied prospectively. H. pylori-infected patients were randomized to receive 10-day sequential therapy [rabeprazole (40 mg daily) plus amoxicillin (1 g twice daily) for the first 5 days, followed by rabeprazole (20 mg), clarithromycin (500 mg) and tinidazole (500 mg) twice daily for the remaining 5 days] or standard 7-day therapy [corrected] [rabeprazole (20 mg), clarithromycin (500 mg) and amoxicillin (1 g) twice daily]. H. pylori status was assessed by histology, rapid urease test and 13C-urea breath test at baseline and 6 weeks or more after completion of treatment.
  
  
  RESULTS
  Higher eradication rates were found with the sequential regimen compared to the standard regimen (intention-to-treat: 92% vs. 74%, P < 0.0001; per protocol: 95% vs. 77%, P < 0.0001). Higher eradication rates were also seen in patients with peptic ulcer disease and non-ulcer dyspepsia. In both treatments, compliance was similar (> 90%), as was the rate of side-effects, which were mild.
  
  
  CONCLUSIONS
  This 10-day sequential treatment regimen achieves high eradication rates in peptic ulcer disease and non-ulcer dyspepsia.
authors.affiliation: GI Unit, Nuovo Regina Margherita Hospital, Rome, Italy. zullo@tiscali.it
authors.forename: A
authors.initials: A
authors.lastname: Zullo
authors.forename: D
authors.initials: D
authors.lastname: Vaira
authors.forename: N
authors.initials: N
authors.lastname: Vakil
authors.forename: C
authors.initials: C
authors.lastname: Hassan
authors.forename: L
authors.initials: L
authors.lastname: Gatta
authors.forename: C
authors.initials: C
authors.lastname: Ricci
authors.forename: V
authors.initials: V
authors.lastname: De Francesco
authors.forename: M
authors.initials: M
authors.lastname: Menegatti
authors.forename: A
authors.initials: A
authors.lastname: Tampieri
authors.forename: F
authors.initials: F
authors.lastname: Perna
authors.forename: V
authors.initials: V
authors.lastname: Rinaldi
authors.forename: F
authors.initials: F
authors.lastname: Perri
authors.forename: C
authors.initials: C
authors.lastname: Papadìa
authors.forename: F
authors.initials: F
authors.lastname: Fornari
authors.forename: S
authors.initials: S
authors.lastname: Pilati
authors.forename: L S
authors.initials: LS
authors.lastname: Mete
authors.forename: A
authors.initials: A
authors.lastname: Merla
authors.forename: R
authors.initials: R
authors.lastname: Potì
authors.forename: G
authors.initials: G
authors.lastname: Marinone
authors.forename: A
authors.initials: A
authors.lastname: Savioli
authors.forename: S M A
authors.initials: SM
authors.lastname: Campo
authors.forename: D
authors.initials: D
authors.lastname: Faleo
authors.forename: E
authors.initials: E
authors.lastname: Ierardi
authors.forename: M
authors.initials: M
authors.lastname: Miglioli
authors.forename: S
authors.initials: S
authors.lastname: Morini
mesh_terms: D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D000658:Amoxicillin / Q000627:therapeutic use*; D001562:Benzimidazoles / Q000627:therapeutic use*; D017291:Clarithromycin / Q000627:therapeutic use*; D004359:Drug Therapy, Combination / Q000627:therapeutic use*; D004415:Dyspepsia / Q000382:microbiology*; D005260:Female; D016481:Helicobacter Infections / Q000150:complications / Q000188:drug therapy*; D016480:Helicobacter pylori; D006801:Humans; D008297:Male; D008875:Middle Aged; D009853:Omeprazole / Q000031:analogs & derivatives; D010349:Patient Compliance; D064750:Rabeprazole; D014011:Tinidazole / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D001562:Benzimidazoles; D014011:Tinidazole; D064750:Rabeprazole; D000658:Amoxicillin; D017291:Clarithromycin; D009853:Omeprazole