Concomitant, sequential, and hybrid therapy for H. pylori eradication: a pilot study

Area of Science:

• Gastroenterology
• Infectious Diseases
• Pharmacology

Background:

• Standard triple therapies for H. pylori eradication are becoming less effective.
• Novel antibiotic regimens like concomitant, sequential, and hybrid therapies have been developed.

Purpose of the Study:

• To compare the efficacy of concomitant, sequential, and hybrid therapies for H. pylori eradication.
• To evaluate the success rate of second-line levofloxacin-based therapy.

Main Methods:

• A multicenter, open-label pilot study randomized 270 treatment-naïve patients with H. pylori infection.
• Patients received either 5-day concomitant, 10-day sequential, or 14-day hybrid therapy.
• Eradication was assessed via (13)C-urea breath test 6 weeks post-treatment; failures received second-line therapy.

Main Results:

• Concomitant therapy achieved 85.5% (ITT) eradication, sequential therapy 91.1% (ITT), and hybrid therapy 80% (ITT).
• Per-protocol analysis showed rates of 91.6%, 92.1%, and 85.7% respectively.
• Second-line levofloxacin-based therapy cured H. pylori in 55.6% of patients.

Conclusions:

• Concomitant and sequential therapies demonstrated high H. pylori eradication rates, unlike hybrid therapy.
• The efficacy of second-line levofloxacin-based triple therapy for H. pylori eradication is decreasing.