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Updated: Mar 19, 2026
Author Spotlight: Detection and Treatment of Helicobacter pylori Infection
Published on: July 28, 2023
Two-week Triple Therapy with either Standard or High-dose Esomeprazole for First-line H. pylori Eradication
Vincenzo De Francesco1, Lorenzo Ridola2, Cesare Hassan3
1Gastroenterology Unit, Riuniti Hospital, Foggia, Italy. vdefrancesco@ospedaliriunitifoggia.it.
Background And Aims:
The updated Italian guidelines advise a standard 14-day triple therapy for first-line H. pylori eradication. This prospective study evaluated the cure rate following a 14-day triple therapy with either a standard or double-dose proton pump inhibitor (PPI).
Methods:
A total of 145 consecutive patients with H. pylori infection were randomized to receive a 14-day, first-line triple therapy with clarithromycin 500 mg, amoxicillin 1 g and esomeprazole at either 20 mg (standard therapy) or 40 mg (double-dose therapy), each given twice daily.
Results:
At intention-to-treat analysis, H. pylori infection was cured in 73.9% (95% CI: 63.9-84) and 81.9% (95% CI: 73-90.8) following standard and double-dose therapy, respectively, and in 78.2% (95% CI: 68.5-87.9) and 85.5% (95% CI: 77.2-93.8) at per-protocol analysis. No statistically significant difference occurred. Overall, 16.4% and 19.4% patients in the standard and double-dose therapy regimen complained of side effects.
Conclusion:
The success rate of both standard and double-dose 14-day triple therapies for first-line H. pylori treatment was unsatisfactory. A prolonged 14-day levofloxacin-based triple therapy for second-line H. pylori eradication seems to be promising.
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