Standard triple therapy versus sequential therapy for eradication of Helicobacter pylori in treatment naive and retreat patients

ABSTRACT

Background and study aims: Untreated Helicobacter pylori infection causes increased risk of gastric cancer, GI morbidity and mortality. Standard treatment for eradication of Helicobacter pylori infection, is the triple therapy which consists of a proton pump inhibitor; together with two antibiotics [amoxicillin 1000 mg with clarithromycin 500 mg or metronidazole 400 mg] given twice daily for 7-14 days. Recent evidence revealed, that cure rates of Helicobacter pylori infection with triple therapy had fallen below satisfactory targets. Sequential therapy consisting of a twice daily dose of a PPI for ten days with Amoxicillin given at 1000 mg twice daily in the first 5 days followed by clarithromycin 500 mg and Metronidazole 400 mg given twice daily in the subsequent 5 days, was recommended to improve eradication rates. We performed a randomised open label study to compare the efficacy of sequential against triple therapy in Helicobacter pylori naive and retreat patients