title: Comparison of Helicobacter pylori eradication rates of standard 14-day quadruple treatment and novel modified 10-day, 12-day and 14-day sequential treatments.
abstract: OBJECTIVE
  This study aimed to compare the efficacy and safety of bismuth-included standard regimen and modified sequential treatments in Turkey, where the success rate of standard triple therapy is very low.
  
  
  METHODS
  One-hundred and sixty patients with dyspeptic complaints and naïve Helicobacter pylori infection were randomized into four groups: 41 patients received standard 14-day quadruple treatment (STD) (Rabeprazole 20mg-bid, bismuth subcitrate (120 mg-qid), Tetracycline 500 mg-qid, Metronidazole 500 mg-tid) for 2 weeks. The modified sequential therapy groups received 20 mg rabeprazole and 1g amoxicillin, twice daily for the first 5 days, followed by Rabeprazole 20mg-bid, bismuth subcitrate (120 mg-qid), Tetracycline 500 mg-qid, Metronidazole 500 mg-tid for the remaining 5 (10 day sequential therapy group-10S) (42 patients), 7 (12 day sequential therapy group-12S) (42 patients) and 9 (14 day sequential therapy group-14S) (41 patients) days.
  
  
  RESULTS
  The overall compliance and H. pylori eradication rate among the 160 patients who completed the H. pylori eradication regimens were 86.9% (139/160) and 78.1% (125/160), respectively. The results were not statistically different between groups in the eradication rates. Per-protocol eradication rates were 76.5% in STD, 71.4% in 10S, 82.4% in 12S and 83.3% in 14S groups (p=0.7). Intention-to-treatment rates were 77.5% in STD, 72.5% in 10S, 82.5% in 12S and 80.0% in 14S groups (p=0.5).
  
  
  CONCLUSIONS
  The eradication rates of standard 14-day and different sequential quadruple treatment regimens are comparable and much more higher than with standard 14-day triple H. pylori eradication treatment that has been reported previously in Turkey.
authors.affiliation: Department of Gastroenterology, Kırıkkale University Faculty of Medicine, Kirikkale, Turkey.
authors.forename: Ferdane
authors.initials: F
authors.lastname: Sapmaz
authors.affiliation: Department of Gastroenterology, Kırıkkale University Faculty of Medicine, Kirikkale, Turkey. Electronic address: drismailster@gmail.com.
authors.forename: Ismail Hakki
authors.initials: IH
authors.lastname: Kalkan
authors.affiliation: Department of Gastroenterology, Kırıkkale University Faculty of Medicine, Kirikkale, Turkey.
authors.forename: Sefa
authors.initials: S
authors.lastname: Güliter
authors.affiliation: Department of Pathology, Kırıkkale University Faculty of Medicine, Kirikkale, Turkey.
authors.forename: Pınar
authors.initials: P
authors.lastname: Atasoy
mesh_terms: D000328:Adult; D000890:Anti-Infective Agents / Q000008:administration & dosage*; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D005260:Female; D016481:Helicobacter Infections / Q000188:drug therapy*; D016480:Helicobacter pylori; D006801:Humans; D008297:Male; D008795:Metronidazole / Q000008:administration & dosage*; D008875:Middle Aged; D009942:Organometallic Compounds / Q000008:administration & dosage*; D011446:Prospective Studies; D054328:Proton Pump Inhibitors / Q000008:administration & dosage*; D064750:Rabeprazole / Q000008:administration & dosage*; D012074:Remission Induction; D013752:Tetracycline / Q000008:administration & dosage*; D013997:Time Factors; D014421:Turkey
chemical_list: D000890:Anti-Infective Agents; D009942:Organometallic Compounds; D054328:Proton Pump Inhibitors; D008795:Metronidazole; D064750:Rabeprazole; D013752:Tetracycline; C002791:bismuth tripotassium dicitrate
keywords: Eradication; Failure; H. pylori; Quadruple treatment; Sequential