title: Triple therapy versus sequential therapy for the first-line Helicobacter pylori eradication.
abstract: BACKGROUND
  The eradication rate of Helicobacter pylori (H. pylori) with triple therapy which was considered as standard first-line treatment has decreased to 70-85%. The aim of this study is to compare 7-day triple therapy versus 10-day sequential therapy as the first line treatment.
  
  
  METHODS
  Data of 1240 H. pylori positive patients treated with triple therapy or sequential therapy from January 2013 to December 2015 were analyzed retrospectively. The patients who had undertaken previous H. pylori eradication therapy or gastric surgery were excluded.
  
  
  RESULTS
  There were 872 (74.3%) patients in the triple therapy group, and 302 (25.7%) patients in the sequential therapy group. There was no significant difference between the two groups regarding age, residence, comorbidities or drug compliance, but several differences were noted in endoscopic characteristics and indication for the treatment. The eradication rate of H. pylori by intention to treat analysis was 64.3% in the triple therapy group, and 81.9% in the sequential therapy group (P = 0.001). In per protocol analysis, H. pylori eradication rate in the triple therapy and sequential therapy group was 81.9 and 90.3%, respectively (P = 0.002). There was no significant difference in overall adverse events between the two groups (P = 0.706). For the rescue therapy, bismuth-containing quadruple therapy showed comparable treatment efficacy after sequential therapy, as following triple therapy.
  
  
  CONCLUSIONS
  The eradication rate of triple therapy was below the recommended threshold. Sequential therapy could be effective and tolerable candidate for the first-line H. pylori eradication therapy.
authors.affiliation: Department of Internal Medicine, Ewha Womans University School of Medicine, Ewha Medical Research Institute, 1071 Anyangcheon-ro, Yangcheon-gu, Seoul, 158-710, South Korea.
authors.forename: Ji Young
authors.initials: JY
authors.lastname: Chang
authors.affiliation: Department of Internal Medicine, Ewha Womans University School of Medicine, Ewha Medical Research Institute, 1071 Anyangcheon-ro, Yangcheon-gu, Seoul, 158-710, South Korea. shimkn@ewha.ac.kr.
authors.forename: Ki-Nam
authors.initials: KN
authors.lastname: Shim
authors.affiliation: Department of Internal Medicine, Ewha Womans University School of Medicine, Ewha Medical Research Institute, 1071 Anyangcheon-ro, Yangcheon-gu, Seoul, 158-710, South Korea.
authors.forename: Chung Hyun
authors.initials: CH
authors.lastname: Tae
authors.affiliation: Department of Internal Medicine, Ewha Womans University School of Medicine, Ewha Medical Research Institute, 1071 Anyangcheon-ro, Yangcheon-gu, Seoul, 158-710, South Korea.
authors.forename: Ko Eun
authors.initials: KE
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, Ewha Womans University School of Medicine, Ewha Medical Research Institute, 1071 Anyangcheon-ro, Yangcheon-gu, Seoul, 158-710, South Korea.
authors.forename: Jihyun
authors.initials: J
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, Ewha Womans University School of Medicine, Ewha Medical Research Institute, 1071 Anyangcheon-ro, Yangcheon-gu, Seoul, 158-710, South Korea.
authors.forename: Kang Hoon
authors.initials: KH
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, Ewha Womans University School of Medicine, Ewha Medical Research Institute, 1071 Anyangcheon-ro, Yangcheon-gu, Seoul, 158-710, South Korea.
authors.forename: Chang Mo
authors.initials: CM
authors.lastname: Moon
authors.affiliation: Department of Internal Medicine, Ewha Womans University School of Medicine, Ewha Medical Research Institute, 1071 Anyangcheon-ro, Yangcheon-gu, Seoul, 158-710, South Korea.
authors.forename: Seong-Eun
authors.initials: SE
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Ewha Womans University School of Medicine, Ewha Medical Research Institute, 1071 Anyangcheon-ro, Yangcheon-gu, Seoul, 158-710, South Korea.
authors.forename: Hye-Kyung
authors.initials: HK
authors.lastname: Jung
authors.affiliation: Department of Internal Medicine, Ewha Womans University School of Medicine, Ewha Medical Research Institute, 1071 Anyangcheon-ro, Yangcheon-gu, Seoul, 158-710, South Korea.
authors.forename: Sung-Ae
authors.initials: SA
authors.lastname: Jung
mesh_terms: D000658:Amoxicillin / Q000008:administration & dosage* / Q000009:adverse effects; D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000009:adverse effects; D017291:Clarithromycin / Q000008:administration & dosage* / Q000009:adverse effects; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D005260:Female; D016481:Helicobacter Infections / Q000188:drug therapy*; D016480:Helicobacter pylori; D006801:Humans; D057194:Intention to Treat Analysis; D008297:Male; D008795:Metronidazole / Q000008:administration & dosage* / Q000009:adverse effects; D008875:Middle Aged; D012189:Retrospective Studies; D017211:Treatment Failure
chemical_list: D000900:Anti-Bacterial Agents; D008795:Metronidazole; D000658:Amoxicillin; D017291:Clarithromycin
keywords: Anti-bacterial agents; First-line triple therapy; Helicobacter pylori; Sequential therapy