title: Comparison of 7-day and 14-day proton pump inhibitor-containing triple therapy for Helicobacter pylori eradication: neither treatment duration provides acceptable eradication rate in Korea.
abstract: OBJECTIVE
  Although triple combination therapy containing a proton pump inhibitor (PPI) and two antibiotics is considered as a standard regimen for the first-line anti-Helicobacter pylori treatment, there are still debates on the ideal duration of treatment. The aim of this study was to compare the efficacies of 7-day and 14-day PPI-containing triple therapy.
  
  
  METHODS
  This study was performed in a randomized, multicenter, prospective manner. After upper gastrointestinal endoscopy, H. pylori-infected patients with a gastric ulcer and/or a duodenal ulcer were randomly assigned to a PAC7 group (omeprazole 20 mg or equivalent dose of other PPIs, amoxicillin 1000 mg, and clarithromycin 500 mg twice daily for 7 days) or to a PAC14 group (the same regimen as the PAC7 group but for 14 days). H. pylori status was evaluated by (13)C urea breath test 5 weeks after anti-ulcer treatment completion.
  
  
  RESULTS
  A total of 598 patients were enrolled; 337 were randomized to the PAC7 group and 261 to the PAC14 group. The two groups were comparable in terms of baseline characteristics. The eradication rates of the PAC7 group were not inferior to those of the PAC14 group in both intention-to-treat analysis (71.2% vs. 75.5%) and per-protocol analysis (83.6% vs. 86.6%). Incidences of adverse events were comparable.
  
  
  CONCLUSIONS
  Although the 7-day PPI-containing triple anti-H. pylori therapy is not inferior to the 14-day therapy, neither treatment duration provides acceptable eradication rate reaching 90% in per-protocol analysis. New combination regimen with higher efficacy should be developed as a first-line eradication therapy for H. pylori in Korea.
authors.affiliation: Department of Internal Medicine, Seoul National University Boramae Hospital, Seoul, Korea.
authors.forename: Byeong Gwan
authors.initials: BG
authors.lastname: Kim
authors.forename: Dong Ho
authors.initials: DH
authors.lastname: Lee
authors.forename: Byong Duk
authors.initials: BD
authors.lastname: Ye
authors.forename: Kwang Hyuck
authors.initials: KH
authors.lastname: Lee
authors.forename: Beung Wook
authors.initials: BW
authors.lastname: Kim
authors.forename: Sang Gyun
authors.initials: SG
authors.lastname: Kim
authors.forename: Sang Woo
authors.initials: SW
authors.lastname: Kim
authors.forename: Sung Kook
authors.initials: SK
authors.lastname: Kim
authors.forename: Jae J
authors.initials: JJ
authors.lastname: Kim
authors.forename: Hak Yang
authors.initials: HY
authors.lastname: Kim
authors.forename: Jong Jae
authors.initials: JJ
authors.lastname: Park
authors.forename: Chang Young
authors.initials: CY
authors.lastname: Park
authors.forename: Gwang Ho
authors.initials: GH
authors.lastname: Baik
authors.forename: Yong Chan
authors.initials: YC
authors.lastname: Lee
authors.forename: Jun Haeng
authors.initials: JH
authors.lastname: Lee
authors.forename: Jin Hyug
authors.initials: JH
authors.lastname: Lee
authors.forename: Hoon Jai
authors.initials: HJ
authors.lastname: Chun
authors.forename: Ki Baik
authors.initials: KB
authors.lastname: Hahm
authors.forename: Su Jin
authors.initials: SJ
authors.lastname: Hong
authors.forename: Sang Woo
authors.initials: SW
authors.lastname: Lee
authors.forename: Hyun Chae
authors.initials: HC
authors.lastname: Jung
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000658:Amoxicillin / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D017291:Clarithromycin / Q000627:therapeutic use; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D005260:Female; D016481:Helicobacter Infections / Q000188:drug therapy*; D016480:Helicobacter pylori; D006801:Humans; D007723:Korea; D008297:Male; D008875:Middle Aged; D009853:Omeprazole; D054328:Proton Pump Inhibitors; D017494:Proton Pumps / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D054328:Proton Pump Inhibitors; D017494:Proton Pumps; D000658:Amoxicillin; D017291:Clarithromycin; D009853:Omeprazole