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KMID : 0614620080510050280
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Korean Journal of Gastroenterology
2008 Volume.51 No. 5 p.280 ~ p.284
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Effectiveness of 10 Day-sequential Therapy for Helicobacter pylori Eradication in Korea
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Choi Woo-Hyuk
Park Dong-Il
Oh Suk-Joong
Baek Yoo-Hum
Hong Cheul-Ho
Hong Eun-Jung
Song Min-Jun
Park Sung-Keun
Park Jung-Ho
Kim Hong-Joo
Cho Young-Kyun
Sohn Chong-Il
Jeon Woo-Kyu
Kim Byung-Ik
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Abstract
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Background/Aims: Antibiotic resistance and poor compliance are the main causes of Helicobacter pylori (H. pylori) eradication failure. Proton pump inhibitor (PPI)-based triple therapy is the most preferred regimen in clinical practice. However, a critical fall in the H. pylori eradication rate has been observed in the recent years. A novel 10 day-sequential therapy consists of five days of dual therapy followed by five days of triple therapy regimen has recently been described. We aimed to evaluate whether 10 day-sequential therapy eradicated H. pylori infection better than the PPI-based triple therapy in Korea.
Methods: 158 patients with proven H. pylori infection were randomized to receive either 10 day-sequential therapy (20 mg of omeprazole, 1.0 g of amoxicillin, each administered twice daily for the first 5 days, followed by 20 mg of omeprazole, 500 mg of clarithromycin, 500 mg of metronidazole, each administered twice daily for the remaining 5 days) or PPI-based triple therapy (20 mg of omeprazole, 1.0 g of amoxicillin, 500 mg of clarithromycin, each administered twice daily for 1 week). Outcome of eradication therapy was assessed 8 weeks after the cessation of treatment.
Results: Eradication rates of 10 day-sequential therapy and PPI-based triple therapy were 77.9% (60/77) and 71.6% (58/81) by intention to treat analysis, respectively (p=0.361). By per protocol analysis, eradication rates of 10 day-sequential therapy and triple therapy were 85.7% (60/70) and 76.6% (58/76), respectively (p=0.150). There were no significant differences in adverse event rates and treatment compliance between two groups.
Conclusion: The 10 day-sequential therapy regimen failed to achieve significantly higher eradication rates than PPI-based triple therapy.
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KEYWORD
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Helicobacter pylori, Sequential therapy, Eradication rate
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