Comparison of the efficacy of the two tetracycline-containing sequential therapy regimens for the eradication of Helicobacter pylori: 5 days versus 14 days amoxicillin.
OBJECTIVE
To compare the efficacy of 14-day and 5-day amoxicillin treatment on the eradication rate during tetracycline containing sequential H. pylori therapy, and also to compare the eradication rate of this regimen with those used in similar studies performed in Turkey.


METHODS
This study included 112 patients infected with H. pylori that were randomized into 2 groups. In group A, patients (n = 56) received pantoprazole (40 mg BID) and amoxicillin (1 g BID) for 5 days, followed by pantoprazole (40 mg BID), tetracycline (500 mg QID), and metronidazole (500 mg TID) for the remaining 9 days. In group B, patients (n = 56) received pantoprazole (40 mg BID) and amoxicillin (1 g BID) for 5 days, followed by pantoprazole (40 mg BID), tetracycline (500 mg QID), metronidazole (500 mg TID), and amoxicillin (1 g BID) for the remaining 9 days. Eradication rates were calculated using both intention-to-treat (ITT) and per-protocol (PP) analyses.


RESULTS
In all, 112 patients were subjected to ITT analysis and 109 patients completed the study. In group A, H. pylori eradication was achieved in 46 (82.1%) of the 56 patients included in the ITT analysis and in 46 (83.6%) of the 55 patients included in the PP analysis. In group B, H. pylori eradication was achieved in 44 (78.57%) of the 56 patients included in the ITT analysis and in 44 (81.48%) of the 54 patients included in the PP analysis (Table 2). The eradication rates were not statistically significant between the 2 groups (p > .005).


CONCLUSIONS
Extended duration of amoxicillin treatment during the entire tetracycline containing sequential therapy period did not improve the H. pylori eradication rate. As a consequence, sequential therapy using 5-day amoxicillin is an acceptable first-line therapy option for the eradication of H. pylori in Turkey.
Cetinkaya
Züleyha A
ZA
Gastroenterohepatology Department, Haydarpaşa Numune Research and Education Hospital, Istanbul, Turkey. zakkan2000@yahoo.com
Sezikli
Mesut
M
Güzelbulut
Fatih
F
Coşgun
Süleyman
S
Düzgün
Serkan
S
Kurdaş
Oya O
OO
D053799:2-Pyridinylmethylsulfinylbenzimidazoles / Q000008:administration & dosage; D000328:Adult; D000658:Amoxicillin / Q000008:administration & dosage*; D000818:Animals; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D005260:Female; D016481:Helicobacter Infections / Q000188:drug therapy*; D016480:Helicobacter pylori / Q000187:drug effects / Q000302:isolation & purification; D006801:Humans; D008297:Male; D008795:Metronidazole / Q000008:administration & dosage; D008875:Middle Aged; D000077402:Pantoprazole; D054328:Proton Pump Inhibitors / Q000008:administration & dosage; D013752:Tetracycline / Q000008:administration & dosage*; D013997:Time Factors; D016896:Treatment Outcome; D014421:Turkey
D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D000900:Anti-Bacterial Agents; D054328:Proton Pump Inhibitors; D008795:Metronidazole; D000658:Amoxicillin; D000077402:Pantoprazole; D013752:Tetracycline