Sequential therapy versus standard triple-drug therapy for Helicobacter pylori eradication: a randomized study

Area of Science:

• Gastroenterology
• Infectious Diseases
• Pharmacology

Background:

• Antimicrobial resistance is reducing Helicobacter pylori eradication success globally.
• Previous studies on sequential treatment efficacy were limited to Italy.
• This study aimed to validate sequential therapy's effectiveness in an Indian population.

Purpose of the Study:

• To compare the efficacy of a 10-day sequential treatment regimen versus standard 14-day triple therapy for H. pylori eradication in India.
• To assess the eradication rates and side effects of both treatment protocols.

Main Methods:

• A randomized, open-labeled, prospective controlled trial involving 231 dyspeptic patients.
• Patients received either a 10-day sequential regimen (pantoprazole, amoxicillin, clarithromycin, tinidazole) or a 14-day standard triple therapy (pantoprazole, clarithromycin, amoxicillin).

Main Results:

• The sequential regimen achieved a significantly higher per-protocol eradication rate (92.4%) than triple therapy (81.8%) (p=0.027).
• Intention-to-treat analysis also showed superior eradication with sequential therapy (88.2%) versus standard therapy (79.1%) (p=0.029).
• No significant difference in the incidence of major or minor side effects was observed between the groups.

Conclusions:

• Sequential therapy demonstrated significantly superior efficacy in eradicating H. pylori infection compared to standard triple therapy.
• The findings suggest sequential therapy is a more effective treatment strategy for H. pylori in the Indian context.