Sequential Treatment for Helicobacter Pylori Eradication in Peptic Ulcer Patients

Objective:To assess the efficacy and safety of a 10-day sequential regimen compared with conventional 7-day and 14-day triple therapies.Methods: Overall,113 Helicobacter pylori(H.pylori) infected patients with peptic ulcer were enrolled.All patients were randomized either to receive 10-day sequential therapy Group A,pantoprazole plus amoxicillin for the first 5 days,followed by pantoprazole,clarithromycin and tinidazole twice daily for the remaining 5 days or to standard 7-day therapy Group B,pantoprazole,clarithromycin and amoxicillin twice daily,or standard 14-day therapy Group C.Four weeks after therapy.H.pylori eradication was assessed by 14C-urea breath test.Results:H.pylori eradication was achieved in 34(87.18%) of 39 individuals in Group A,34(91.89%) of 37 in Group C and 30(81.08%) of 39 in Group B Sequential regimen and the 10-day showed a significant gain in the eradication rate as compared to the 7-day(P0.05) while there was no significant difference between Group A and Group C(P0.05).Adverse drug events were similar in these three groups.Conclusions: The sequential regimen and standard 14-day therapy achieved higher cure rate than standard 7-day therapy.The sequential regimen had the lowest cost-effective ratio.The 10-day sequential regimen is significantly more effective,economic and safe than both triple regimens.