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Randomiozed clinical trial: a comparative study of 10 day sequencial therapy with 7-day standard triple therapy for Helicobacter pylori infection in naive patients

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Author(s)
김은수조광범박경식
Alternative Author(s)
Kim, Eun SooCho, Kwang BumPark, Kyung Sik
Publication Year
2012
Abstract
Background
The eradication rates following standard triple therapy for Helicobacter
pylori infection are declining worldwide. Recent studies have shown that
sequential therapy for H. pylori infection yields high cure rates.
Aim
To compare the efficacy and tolerability of a sequential regimen as first-line
treatment of H. pylori infection with a standard triple regimen.
Methods
A total of 348 naı
¨
ve H. pylori-infected patients from six hospitals in Korea
were assigned randomly to standard triple or sequential therapy groups.
Standard triple therapy consisted of 20 mg of rabeprazole, 1 g of amoxicil-
lin and 500 mg of clarithromycin, twice daily for 7 days. Sequential therapy
consisted of a 5-day dual therapy (20 mg of rabeprazole and 1 g of amoxi-
cillin, twice daily) followed by a 5-day triple therapy (20 mg of rabeprazole,
500 mg of clarithromycin, and 500 mg of metronidazole, twice daily).
Results
The intention-to-treat (ITT) and per-protocol (PP) eradication rates were
62.2% (95% CI 54.8–69.6%) and 76.0% (95% CI 68.5–83.5%) in the stan-
dard triple group, and 77.8% (95% CI 71.4–84.2%) and 87.9% (95% CI
82.3–93.5%) in the sequential group, respectively. The eradication rate was
significantly higher in the sequential group compared with the standard tri-
ple group in both the ITT and PP populations (P = 0.002 and P = 0.013
respectively), whereas the incidence of adverse events was similar.
Conclusions
Ten-day sequential therapy is more effective and equally tolerated for eradi-
cation of H. pylori infection compared with standard triple therapy. Sequen-
tial therapy may have a role as first-line treatment for H. pylori infection.
Department
Dept. of Internal Medicine (내과학)
Publisher
School of Medicine
Citation
Alimentary Pharmacology & Therapeutics, Vol.35(1) : 56-65, 2012
Type
Article
ISSN
0269-2813
DOI
10.1111/j.1365-2036.2011.04902.x
URI
http://kumel.medlib.dsmc.or.kr/handle/2015.oak/34880
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