Ten-day sequential therapy is more effective than proton pump inhibitor-based therapy in Korea: a prospective, randomized study |
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Authors: | Oh Hong Sang Lee Dong Ho Seo Ji Yeon Cho Yu Ri Kim Nayoung Jeoung Sook Hyang Kim Jin Wook Hwang Jin Hyeok Park Young Soo Lee Sang Hyub Shin Cheol Min Cho Hyun Jin Jung Hyun Chae Song In Sung |
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Institution: | Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea. |
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Abstract: | Background and Aims: The eradication rate of proton pump inhibitor (PPI)‐based triple therapy for Helicobacter pylori (H. pylori) infection has decreased, mainly due to increasing antibiotic resistance, especially against clarithromycin. It has been reported that a 10‐day sequential strategy can produce good outcomes. The aim of this prospective study was to assess the efficacy of sequential therapy as the first‐line treatment for the eradication of H. pylori in Korea. Methods: A total of 116 patients with proven H. pylori infection received 10‐day sequential therapy (20 mg rabeprazole and 1 g amoxicillin, twice daily for the first 5 days, followed by 20 mg rabeprazole, 500 mg clarithromycin, and 500 mg metronidazole, twice daily for the remaining 5 days); 130 patients received 7‐day triple therapy (20 mg rabeprazole, 500 mg clarithromycin, and 1 g amoxicillin, twice daily for 7 days). Eradication was evaluated by the 13C‐urea breath test, 4 weeks after the completion of treatment. Compliance and adverse events were assessed. Results: The eradication rates of 10‐day sequential therapy and PPI‐based triple therapy were 79.3% (92/116) and 63% (82/130) by intention‐to‐treat analysis, respectively (P = 0.005), and 81.9% (91/111) and 64.5% (82/127) by per protocol analysis, respectively (P = 0.003). Mild adverse events occurred in both therapy groups (27.5% vs 23.8%), but both treatments were well tolerated. Conclusion: The eradication rate of the 10‐day sequential therapy regimen was significantly higher than that of PPI‐based triple therapy in the Korean population. Ten‐day sequential therapy might be effective as a first‐line treatment for H. pylori infection in Korea. |
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Keywords: | Helicobacter pylori Korea proton pump inhibitor‐based triple therapy ten‐day sequential therapy |
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