Ten-day sequential treatment for Helicobacter pylori eradication in clinical practice.
BACKGROUND
Cure rates of Helicobacter pylori infection with standard triple therapy are disappointingly low. A very effective, new sequential treatment schedule has recently been described. However, all studies published to date were performed in Italy; it is mandatory to confirm these results in other settings.


OBJECTIVE
To assess the cure rate and the acceptability of a new sequential treatment regimen through a pilot study.


METHODS
A hundred and thirty-nine patients (60% men, mean age 49.6 +/- 15.7 yr) were recruited from six centers. H. pylori status was assessed by histology, urease test or urea breath test. Sequential regime consisted of a 10-day treatment including a proton pump inhibitor (PPI) b.d. plus amoxicillin 1 g b.d. for the first 5 days, followed by a PPI b.d. clarithromycin 500 mg b.d. and metronidazole 500 mg b.d for the next 5 days. Eradication was determined 8 wk after the end of treatment by urea breath test or histology. Eradication rates were calculated both per protocol and by intention-to-treat.


RESULTS
Eradication was achieved in 117 out of 129 patients who returned for a follow-up test. The intention-to-treat eradication rate was thus 84.2% (95%CI: 77%-90%) and the per-protocol cure rate 90.7% (95%CI: 84%-95%). The treatment was well tolerated. Only 14 patients complained of mild side effects.


CONCLUSIONS
Sequential treatment seems highly effective for eradicating H. pylori.
Sánchez-Delgado
Jordi
J
Hospital de Sabadell, Institut Universitari Parc Taulí, Departament de Medicina, UAB, Barcelona, Spain.
Calvet
Xavier
X
Bujanda
Luis
L
Gisbert
Javier P
JP
Titó
Llúcia
L
Castro
Manuel
M
D000658:Amoxicillin / Q000008:administration & dosage; D000890:Anti-Infective Agents / Q000008:administration & dosage*; D001944:Breath Tests; D017291:Clarithromycin / Q000008:administration & dosage; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D005260:Female; D016481:Helicobacter Infections / Q000188:drug therapy*; D016480:Helicobacter pylori; D006801:Humans; D016015:Logistic Models; D008297:Male; D008795:Metronidazole / Q000008:administration & dosage; D008875:Middle Aged; D010865:Pilot Projects; D054328:Proton Pump Inhibitors / Q000008:administration & dosage*; D016896:Treatment Outcome
D000890:Anti-Infective Agents; D054328:Proton Pump Inhibitors; D008795:Metronidazole; D000658:Amoxicillin; D017291:Clarithromycin