Gut Liver.
2016 Jul;10(4):556-561. 10.5009/gnl15470.
Sequential Therapy versus Triple Therapy for the First Line Treatment of Helicobacter pylori in Korea: A Nationwide Randomized Trial
- Affiliations
-
- 1Department of Internal Medicine, Incheon St. Mary's Hospital, The Catholic University of Korea College of Medicine, Incheon, Korea. gastro@catholic.ac.kr
- 2Department of Internal Medicine, Soonchunhyang University College of Medicine, Bucheon, Korea.
- 3Department of Internal Medicine, Yeouido St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea.
- 4Department of Internal Medicine, Ewha Medical Research Institute, Ewha Womans University School of Medicine, Seoul, Korea.
- 5Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
- 6Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, Korea.
- 7Department of Internal Medicine, Chonbuk National University Medical School, Jeonju, Korea.
- 8Department of Internal Medicine, Jeju National University School of Medicine, Jeju, Korea.
- 9Department of Internal Medicine, Inje University Busan Paik Hospital, Inje Univeristy College of Medicine, Busan, Korea.
- KMID: 2412043
- DOI: http://doi.org/10.5009/gnl15470
Abstract
- BACKGROUND/AIMS
Eradication of Helicobacter pylori infection with standard triple therapy (TT) has declined primarily because of increased antibiotic resistance. Sequential therapy (ST) has been suggested as an alternative to TT for the first-line treatment of H. pylori. The purpose of this study was to compare the efficacy of ST with TT.
METHODS
This was a multicenter, randomized open-label trial performed at nine centers in Korea. Patients with H. pylori infection were randomly assigned to receive either 7 day TT or 10 day ST. Eradication rates, drug compliance, and adverse events were compared among the two regimens.
RESULTS
A total of 601 patients were enrolled between March 2011 and September 2014. The intention-to-treat eradication rates were 70.8% for TT and 82.4% for ST (p=0.001). The corresponding per protocol eradication rates were 76.9% and 88.8% for TT and ST, respectively (p=0.000). There were no statistically significant differences between the two regimens with respect to drug compliance and adverse events.
CONCLUSIONS
ST achieved better eradication rates than TT as a first-line therapy for H. pylori eradication in Korea.
MeSH Terms
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Adult
Aged
Amoxicillin/administration & dosage
Anti-Bacterial Agents/*administration & dosage
Clarithromycin/administration & dosage
Drug Administration Schedule
Drug Therapy, Combination
Female
Helicobacter Infections/*drug therapy
Helicobacter pylori/*drug effects
Humans
Intention to Treat Analysis
Male
Medication Adherence
Metronidazole/administration & dosage
Middle Aged
Proton Pump Inhibitors/*administration & dosage
Republic of Korea
Treatment Outcome
Anti-Bacterial Agents
Proton Pump Inhibitors
Metronidazole
Amoxicillin
Clarithromycin
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