title: Sequential therapy versus standard triple-drug therapy for Helicobacter pylori eradication: result of the HPFEZ randomised study.
abstract: OBJECTIVE
  The aim of this study was to assess and compare the efficacy and safety of sequential treatment with standard triple therapies in a located population in Morocco.
  
  
  METHODS
  Consecutive H. pylori-positive patients with endoscopy-proven ulcer or non ulcer dyspepsia were prospectively randomized in the trial into one of three groups: AM and AC group were administered a tri-therapy for 7 days including PPI + amoxicillin + metronidazole (AM group)/clarithromycin (AC group) and SQ group was administered a sequential regimen consisting of PPI + amoxicillin for 5 days followed by PPI + clarithromycin + metronidazole for the remaining 5 days. Eradication was confirmed by 13C-urea breath test 3 months after the end of the treatment.
  
  
  RESULTS
  Groups AM, AC and SQ included respectively 104, 115 and 104 patients. They were comparable in terms of age, sex, clinical and endoscopic presentation. The rate of H. pylori eradication with sequential therapy was found at 94.2% (n=98) in ITT and 96% (n=98) in PP. It was higher than those found in the AM group: 70% (n=73) in ITT and 70.8% (n=73) in PP and the AC group: 78.2% (n=90) in ITT and 79.6% (n=90) in PP (0.001). The prevalence of side effects following the sequential treatment was 9.6% (n=10) versus 22% (n=22) and 27.8% (n=32) in the AM and AC groups, respectively, (P=0.006).
  
  
  CONCLUSIONS
  Sequential treatment was better tolerated and achieved a significantly higher eradication rate of H. pylori compared with standard triple therapies in this population.
authors.affiliation: Department of Hepato-Gastroenterology, Hassan II University Hospital, Fez, Morocco. m.lahbabi@yahoo.fr
authors.forename: Mounia
authors.initials: M
authors.lastname: Lahbabi
authors.forename: Samia
authors.initials: S
authors.lastname: Alaoui
authors.forename: Karima
authors.initials: K
authors.lastname: El Rhazi
authors.forename: Mohammed
authors.initials: M
authors.lastname: El Abkari
authors.forename: Chakib
authors.initials: C
authors.lastname: Nejjari
authors.forename: Afaf
authors.initials: A
authors.lastname: Amarti
authors.forename: Bahia
authors.initials: B
authors.lastname: Bennani
authors.forename: Mustapha
authors.initials: M
authors.lastname: Mahmoud
authors.forename: Adil
authors.initials: A
authors.lastname: Ibrahimi
authors.forename: Dafr Allah
authors.initials: DA
authors.lastname: Benajah
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000658:Amoxicillin / Q000008:administration & dosage*; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D017291:Clarithromycin / Q000008:administration & dosage*; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D016481:Helicobacter Infections / Q000188:drug therapy*; D016480:Helicobacter pylori; D006801:Humans; D008795:Metronidazole / Q000008:administration & dosage*; D008875:Middle Aged; D011446:Prospective Studies; D054328:Proton Pump Inhibitors / Q000008:administration & dosage*; D016037:Single-Blind Method; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D054328:Proton Pump Inhibitors; D008795:Metronidazole; D000658:Amoxicillin; D017291:Clarithromycin