Comparison of Helicobacter pylori eradication rates of standard 14-day quadruple treatment and novel modified 10-day, 12-day and 14-day sequential treatments.
BACKGROUND & AIM
This study aimed to compare the efficacy and safety of bismuth-included standard regimen and modified sequential treatments in Turkey, where the success rate of standard triple therapy is very low.


METHODS
One-hundred and sixty patients with dyspeptic complaints and naïve Helicobacter pylori infection were randomized into four groups: 41 patients received standard 14-day quadruple treatment (STD) (Rabeprazole 20mg-bid, bismuth subcitrate (120 mg-qid), Tetracycline 500 mg-qid, Metronidazole 500 mg-tid) for 2 weeks. The modified sequential therapy groups received 20 mg rabeprazole and 1g amoxicillin, twice daily for the first 5 days, followed by Rabeprazole 20mg-bid, bismuth subcitrate (120 mg-qid), Tetracycline 500 mg-qid, Metronidazole 500 mg-tid for the remaining 5 (10 day sequential therapy group-10S) (42 patients), 7 (12 day sequential therapy group-12S) (42 patients) and 9 (14 day sequential therapy group-14S) (41 patients) days.


RESULTS
The overall compliance and H. pylori eradication rate among the 160 patients who completed the H. pylori eradication regimens were 86.9% (139/160) and 78.1% (125/160), respectively. The results were not statistically different between groups in the eradication rates. Per-protocol eradication rates were 76.5% in STD, 71.4% in 10S, 82.4% in 12S and 83.3% in 14S groups (p=0.7). Intention-to-treatment rates were 77.5% in STD, 72.5% in 10S, 82.5% in 12S and 80.0% in 14S groups (p=0.5).


CONCLUSION
The eradication rates of standard 14-day and different sequential quadruple treatment regimens are comparable and much more higher than with standard 14-day triple H. pylori eradication treatment that has been reported previously in Turkey.
['Sapmaz|Ferdane|F|', 'Kalkan|Ismail Hakki|IH|', 'Güliter|Sefa|S|', 'Atasoy|Pınar|P|']
D000328:Adult D000890:Anti-Infective Agents D004334:Drug Administration Schedule D004359:Drug Therapy, Combination D005260:Female D016481:Helicobacter Infections D016480:Helicobacter pylori D006801:Humans D008297:Male D008795:Metronidazole D008875:Middle Aged D009942:Organometallic Compounds D011446:Prospective Studies D054328:Proton Pump Inhibitors D064750:Rabeprazole D012074:Remission Induction D013752:Tetracycline D013997:Time Factors D014421:Turkey
Eradication Quadruple treatment Sequential H. pylori Failure