Failure of sequential therapy to eradicate Helicobacter pylori in previously treated subjects.
BACKGROUND
Recently, studies in adults and subsequently in children have demonstrated a very high success rate for sequential therapy as a primary therapy when compared to traditional therapy regimens.


METHODS
We report our experience with a sequential therapy regimen for the eradication of Helicobacter pylori in five infected children and a young adult, whose conventional therapy regimens had been unsuccessful.


RESULTS
Five patients failed the sequential therapy. All of them experienced between two and four failures of traditional therapy prior to the sequential treatment protocol. The only patient who succeeded on the sequential therapy had just one previous failure. All of our patients who had failed sequential therapy achieved eradication of the bacteria with quadruple therapy.


CONCLUSIONS
In view of our disappointing results, sequential therapy is unsuccessful as a therapy for children and young adults who have failed previous treatment regimens. At the present time, quadruple therapy is indicated for this group. Well-designed placebo-controlled trials are indicated to further characterize this group of patients.
Shehada
Suhair
S
Srugo
Isaac
I
Shaoul
Ron
R
D000293:Adolescent; D000328:Adult; D000477:Alkylating Agents / Q000008:administration & dosage / Q000627:therapeutic use; D000658:Amoxicillin / Q000008:administration & dosage / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D002648:Child; D017291:Clarithromycin / Q000008:administration & dosage / Q000627:therapeutic use; D004791:Enzyme Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use; D005260:Female; D016481:Helicobacter Infections / Q000188:drug therapy; D016480:Helicobacter pylori / Q000187:drug effects*; D006801:Humans; D008297:Male; D009853:Omeprazole / Q000008:administration & dosage / Q000627:therapeutic use; D014011:Tinidazole / Q000008:administration & dosage / Q000627:therapeutic use; D017211:Treatment Failure
D000477:Alkylating Agents; D000900:Anti-Bacterial Agents; D004791:Enzyme Inhibitors; D014011:Tinidazole; D000658:Amoxicillin; D017291:Clarithromycin; D009853:Omeprazole