Comparison of Ten-Day Sequential and Standard Triple Therapy for Helicobacter pylori Eradication
Helicobacter pylori (HBP) is reported as one of the main causes of peptic ulcer disease (PUD) and gastric cancer in the world. The challenge for finding an optimal treatment regimen for HBP eradication is still a matter of concern. The aim of this study was to compare the HBP eradication rate as well as side effects between two 10-days treatments of the standard triple and sequential regimen. This study was performed on patients with dyspepsia and HBP positive. Patients were categorized in two treatment groups including; standard (Omeprazole, Amoxicillin, and Clarithromycin) and sequential treatment (Omeprazole, Amoxicillin, Clarithromycin, and Metronidazole). HBP eradication rate, side effects, and treatment costs were compared between two groups. One hundred thirty-two patients (58 males, 74 females) with a mean age of 42.7±14.2-year-old were studied in two groups of Standard Treatment (n=66) and Sequential Treatment (n=66). There were not any significant differences between two groups regarding baseline features. The overall rate of HBP eradication was estimated to be 79.5%. Although, there was not any significant difference between the observed side effects, the mean cost of treatment in standard was significantly lower than that in the sequential group (P=0.001). It seems that there are not any clinical differences between 10-day treatment plan of the standard triple and sequential therapy in the case of HBP eradication and side effects. However, the sequential treatment might be a better option as the economic point of view.
Chung, J.W., et al., Ten-day sequential versus triple therapy for Helicobacter pylori eradication: a prospective, open-label, randomized trial. J Gastroenterol Hepatol, 2012. 27(11): p. 1675-80.
Liou, J.M., et al., Sequential therapy for 10 days versus triple therapy for 14 days in the eradication of Helicobacter pylori in the community and hospital populations: a randomised trial. Gut, 2016. 65(11): p. 1784-1792.
Alsohaibani, F., et al., Prospective trial in Saudi Arabia comparing the 14-day standard triple therapy with the 10-day sequential therapy for treatment of Helicobacter pylori infection. Saudi J Gastroenterol, 2015. 21(4): p. 220-5.
Ben Chaabane, N. and H.S. Al-Adhba, Ciprofloxacin-containing versus clarithromycin-containing sequential therapy for Helicobacter pylori eradication: A randomized trial. Indian J Gastroenterol, 2015. 34(1): p. 68-72.
Gisbert, J.P., et al., Sequential therapy for Helicobacter pylori eradication: a critical review. J Clin Gastroenterol, 2010. 44(5): p. 313-25.
Vaira, D., et al., Sequential Therapy for Helicobacter Pylori Eradication: The Time is Now! Therap Adv Gastroenterol, 2009. 2(6): p. 317-22.
Choi, H.S., et al., Comparison of sequential and 7-, 10-, 14-d triple therapy for Helicobacter pylori infection. World J Gastroenterol, 2012. 18(19): p. 2377-82.
Hsu, P.I., et al., Randomized controlled trial comparing 7-day triple, 10-day sequential, and 7-day concomitant therapies for Helicobacter pylori infection. Antimicrob Agents Chemother, 2014. 58(10): p. 5936-42.
Kutluk, G., et al., Sequential therapy versus standard triple therapy for Helicobacter pylori eradication in children: any advantage in clarithromycin-resistant strains? Eur J Gastroenterol Hepatol, 2014. 26(11): p. 1202-8.
Sardarian, H., et al., Comparison of hybrid and sequential therapies for Helicobacter pylori eradication in Iran: a prospective randomized trial. Helicobacter, 2013. 18(2): p. 129-34.
Laheij, R.J., et al., Evaluation of treatment regimens to cure Helicobacter pylori infection--a meta-analysis. Aliment Pharmacol Ther, 1999. 13(7): p. 857-64.
Fuccio, L., et al., Meta-analysis: can Helicobacter pylori eradication treatment reduce the risk for gastric cancer? Ann Intern Med, 2009. 151(2): p. 121-8.
Katelaris, P.H., et al., A randomized comparison of quadruple and triple therapies for Helicobacter pylori eradication: The QUADRATE Study. Gastroenterology, 2002. 123(6): p. 1763-9.
Moghadaszadeh, M., et al., The comparison between two treatment methods for H. pylori eradication with Two-week sequential regimens.
Hashemi, S.J., et al., Comparison of a triple therapy regimen containing ciprofloxacin and low dose furazolidone with conventional quadruple regimen for Helicobacter pylori eradication. Scientific Medical Journal (AJUMS). 8(4): p. 445-454.
Lim, S.G., et al., The relationship between the failure to eradicate Helicobacter pylori and previous antibiotics use. Dig Liver Dis, 2016. 48(4): p. 385-90.
Uygun, A., et al., Comparison of sequential and standard triple-drug regimen for Helicobacter pylori eradication: a 14-day, open-label, randomized, prospective, parallel-arm study in adult patients with nonulcer dyspepsia. Clin Ther, 2008. 30(3): p. 528-34.
Dajani, A.I., et al., Do probiotics improve eradication response to Helicobacter pylori on standard triple or sequential therapy? Saudi J Gastroenterol, 2013. 19(3): p. 113-20.
De Francesco, V., et al., Effectiveness and pharmaceutical cost of sequential treatment for Helicobacter pylori in patients with non-ulcer dyspepsia. Aliment Pharmacol Ther, 2004. 19(9): p. 993-8.
De Francesco, V., et al., Sequential treatment for Helicobacter pylori does not share the risk factors of triple therapy failure. Aliment Pharmacol Ther, 2004. 19(4): p. 407-14.