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.
Hospital de Sabadell, Institut Universitari Parc Taulí, Departament de Medicina, UAB, Barcelona, Spain.
Jordi
J
Sánchez-Delgado
Xavier
X
Calvet
Luis
L
Bujanda
Javier P
JP
Gisbert
Llúcia
L
Titó
Manuel
M
Castro
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