Korean J Gastroenterol.  2015 Nov;66(5):261-267. 10.4166/kjg.2015.66.5.261.

Ten-day Sequential Therapy versus Bismuth Based Quadruple Therapy as Second Line Treatment for Helicobacter pylori Infection

• Kim SB
• Lee SH
• Kim KO
• Jang BI
• Kim TN

• KMID: 2373354
• DOI: http://doi.org/10.4166/kjg.2015.66.5.261

Abstract

BACKGROUND/AIMS
Ten-day sequential therapy has been evaluated as the first line therapy for Helicobacter pylori eradication but studies on sequential therapy as a second line therapy is lacking. The aim of this study was to compare the efficacy of 10-day sequential therapy and quadruple therapy as second line treatment for H. pylori eradication after failure of standard triple therapy.
METHODS
Patients who did not respond to standard triple therapy for H. pylori eradication were assigned to either 10-day sequential or bismuth based quadruple therapy as second line treatment from January 2009 to December 2014 at Yeungnam University Medical Center. Post treatment H. pylori status was determined by rapid urease test, giemsa staining, or 13C-urea breath test. Eradication rate and side effects of both therapies were compared.
RESULTS
A total of 158 H. pylori infected patients were included and 70 patients were treated by bismuth based quadruple therapy and 88 patients by 10-day sequential therapy. Age and sex were not significantly different between the two groups. Eradication rate was 84.3% (59/70) in quadruple group and 56.8% (50/88) in sequential group. Side effects occurred significantly higher in quadruple group than sequential group (27.1% vs. 11.4%, p=0.011).
CONCLUSIONS
For second line H. pylori eradication after failure of standard triple therapy, bismuth based quadruple therapy showed significantly higher H. pylori eradication rate than 10-day sequential therapy. Further prospective studies are needed to evaluate the efficacy of 10-day sequential therapy as a second line H. pylori eradication treatment.

Keyword

Helicobacter pylori; Eradication; Anti-bacterial agents

MeSH Terms

Adult
Aged
Aged, 80 and over
Anti-Bacterial Agents/adverse effects/pharmacology/*therapeutic use
Bismuth/adverse effects/pharmacology/*therapeutic use
Diarrhea/etiology
Drug Administration Schedule
Drug Therapy, Combination
Female
Helicobacter Infections/*drug therapy
Helicobacter pylori/drug effects
Humans
Male
Middle Aged
Proton Pump Inhibitors/adverse effects/pharmacology/therapeutic use
Retrospective Studies
Risk Factors
Taste Disorders/etiology
Treatment Outcome
Young Adult
Anti-Bacterial Agents
Bismuth
Proton Pump Inhibitors

Figure

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  Fig. 1. Comparison of eradication rate between bismuth based quadruple therapy and 10-day sequential therapy (p＜0.001).

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  Fig. 2. Flow chart. This schematic flow chart shows the number of patients included in this study. STT, standard triple therapy.

Reference

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