Ten-day sequential therapy as first-line treatment for Helicobacter pylori infection in Korea: a retrospective study.
OBJECTIVE
The eradication rate of proton-pump inhibitor-based triple therapy for Helicobacter pylori infection is low due to increasing antibiotics resistance, especially clarithromycin. Recently, it was reported in Europe that a 10-day sequential strategy produced good outcomes. The aim of this study was to assess the efficacy of sequential therapy as first-line treatment for eradication of H. pylori in clinical practice in Korea.


METHODS
A total of 98 patients (mean age 55.2 years and male 47, female 51) with proven H. pylori infection received 10-day sequential therapy (20 mg of rabeprazole, and 1 g of amoxicillin, twice daily for the first 5 days, followed by 20 mg of rabeprazole, 500 mg of clarithromycin, and 500 mg of metronidazole, twice daily for the remaining 5 days). Eradication was evaluated 4 weeks later, after completion of treatment by 13(C)-urea breath testing. Eradication rates were calculated by intention-to-treat (ITT) and by per protocol (PP). Compliance and adverse events were also assessed in study group.


RESULTS
The eradication rate of sequential therapy was 91.8% (90/98) by ITT and same result was reported by PP analysis (89/97). The study group consisted of 66 H. pylori associated gastritis, 7 gastric ulcer, and 25 duodenal ulcer patients (67.3%, 7.1%, 25.5%, respectively). Mild adverse events happened frequently (21.4%) but the treatment was well tolerable. The most common adverse event was a bitter taste (9.2%) followed by nausea and diarrhea (4.1%).


CONCLUSIONS
Ten-day sequential therapy is found to effectively eradicate H. pylori infection as first-line treatment in Korea.
Kwon
Jung H
JH
Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
Lee
Dong H
DH
Song
Byeong J
BJ
Lee
Jung W
JW
Kim
Jin J
JJ
Park
Young S
YS
Kim
Nayoung
N
Jeong
Sook-Hyang
SH
Kim
Jin-Wook
JW
Lee
Sang H
SH
Hwang
Jin H
JH
Jung
Hyun C
HC
Song
In S
IS
D053799:2-Pyridinylmethylsulfinylbenzimidazoles / Q000008:administration & dosage; D000658:Amoxicillin / Q000008:administration & dosage; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D001944:Breath Tests; D017291:Clarithromycin / Q000008:administration & dosage; D005260:Female; D016481:Helicobacter Infections / Q000188:drug therapy*; D016480:Helicobacter pylori / Q000187:drug effects; D006801:Humans; D007723:Korea; D008297:Male; D008795:Metronidazole / Q000008:administration & dosage; D008875:Middle Aged; D054328:Proton Pump Inhibitors / Q000008:administration & dosage*; D064750:Rabeprazole; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D014508:Urea / Q000032:analysis
D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D000900:Anti-Bacterial Agents; D054328:Proton Pump Inhibitors; D008795:Metronidazole; D064750:Rabeprazole; D000658:Amoxicillin; D014508:Urea; D017291:Clarithromycin