title: Sequential therapy achieves a higher eradication rate than standard triple therapy in Taiwan.
abstract: OBJECTIVE
  Most clinical trials concerning sequential therapy have been conducted in Italy. The efficacy of sequential therapy for Helicobacter pylori (H. pylori) eradication in Asia remains unclear. The aim of this study was to compare the efficacy of sequential therapy with standard triple therapy in Taiwan.
  
  
  METHODS
  From January 2005 to December 2009, 233 H. pylori-infected patients receiving either a 10-day sequential therapy (40 mg pantoprazole and 1 g amoxicillin, twice daily, for the initial 5 days, followed by 40 mg pantoprazole, 500 mg clarithromycin, and 500 mg metronidazole, twice daily, for the subsequent 5 days, n = 118) or a 7-day standard triple therapy (40 mg pantoprazole, 500 mg clarithromycin, and 1 g amoxicillin twice daily for 7 days, n = 115) were included in the retrospective study. All the patients underwent a follow-up endoscopy with a rapid urease test and histological examination or a urea breath test at 8 weeks after the end of anti-H. pylori therapy to assess H. pylori status.
  
  
  RESULTS
  Intention-to-treat analysis demonstrated a significantly higher eradication rate for the sequential group than for the triple group (93% vs 80%, respectively, P = 0.003). Per-protocol analysis also showed similar results (93% vs 80%, P = 0.005). Both groups had similar frequencies of adverse events (29% vs 22%) and drug compliance (98% vs 97%).
  
  
  CONCLUSIONS
  Sequential therapy achieves a higher eradication rate than standard triple therapy in Taiwan. The novel treatment can be used as a first-line therapy for H. pylori infection for Taiwanese.
authors.affiliation: Department of Internal Medicine, Kaohsiung Veterans General Hospital and National Yang-Ming University, Kaohsiung, Taiwan.
authors.forename: Feng-Woei
authors.initials: FW
authors.lastname: Tsay
authors.forename: Hui-Hwa
authors.initials: HH
authors.lastname: Tseng
authors.forename: Ping-I
authors.initials: PI
authors.lastname: Hsu
authors.forename: Kai-Ming
authors.initials: KM
authors.lastname: Wang
authors.forename: Ching-Chang
authors.initials: CC
authors.lastname: Lee
authors.forename: Shiuh-Nan
authors.initials: SN
authors.lastname: Chang
authors.forename: Huay-Min
authors.initials: HM
authors.lastname: Wang
authors.forename: Hsien-Chung
authors.initials: HC
authors.lastname: Yu
authors.forename: Wen-Chi
authors.initials: WC
authors.lastname: Chen
authors.forename: Nan-Jing
authors.initials: NJ
authors.lastname: Peng
authors.forename: Kwok-Hung
authors.initials: KH
authors.lastname: Lai
authors.forename: Deng-Chyang
authors.initials: DC
authors.lastname: Wu
mesh_terms: D053799:2-Pyridinylmethylsulfinylbenzimidazoles / Q000008:administration & dosage / Q000009:adverse effects; D000328:Adult; D000367:Age Factors; D000368:Aged; D000658:Amoxicillin / Q000008:administration & dosage / Q000009:adverse effects; D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000009:adverse effects; D001944:Breath Tests; D017291:Clarithromycin / Q000008:administration & dosage / Q000009:adverse effects; D004359:Drug Therapy, Combination / Q000009:adverse effects / Q000379:methods; D005260:Female; D005773:Gastroscopy; D016481:Helicobacter Infections / Q000175:diagnosis / Q000188:drug therapy*; D016480:Helicobacter pylori; D006801:Humans; D057194:Intention to Treat Analysis; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D000077402:Pantoprazole; D054328:Proton Pump Inhibitors / Q000008:administration & dosage* / Q000009:adverse effects; D012189:Retrospective Studies; D013624:Taiwan; D016896:Treatment Outcome; D014510:Urease / Q000032:analysis
chemical_list: D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D000900:Anti-Bacterial Agents; D054328:Proton Pump Inhibitors; D000658:Amoxicillin; D000077402:Pantoprazole; D014510:Urease; D017291:Clarithromycin