Concomitant versus sequential therapy for the treatment of<i>Helicobacter pylori</i>infection: a Greek randomized prospective study

Apostolopoulos, Periklis; Koumoutsos, Ioannis; Ekmektzoglou, Konstantinos; Dogantzis, Panagiotis; Vlachou, Erasmia; Kalantzis, Chrisostomos; Tsibouris, Panagiotis; Alexandrakis, Georgios

doi:10.3109/00365521.2015.1079646

Cited by 32 publications

(30 citation statements)

References 33 publications

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“…These results were even slightly higher than expected according to most recent studies that reported eradication rates ranging from 83% to 95% with CQT [13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29] and from 80% to 95% with BQT. Eradication rate obtained by both strategies was similar and clearly above the recommended 90% eradication rate (CQT 98.0% and BQT 94.4% at ITT analysis).…”

Section: The Addition Of Certain Probiotics (Different Lactobacillus Andcontrasting

confidence: 58%

“…Eradication rate obtained by both strategies was similar and clearly above the recommended 90% eradication rate (CQT 98.0% and BQT 94.4% at ITT analysis). These results were even slightly higher than expected according to most recent studies that reported eradication rates ranging from 83% to 95% with CQT [13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29] and from 80% to 95% with BQT. 25,[30][31][32][33][34][35][36][37][38][39] Since eradication rates of different therapies depend on the H pylori resistance pattern to antibiotics, our results are region specific and only applicable to areas with similar resistance rates to main antibiotics.…”

Section: The Addition Of Certain Probiotics (Different Lactobacillus Andcontrasting

confidence: 58%

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Bismuth‐containing quadruple therapy versus concomitant quadruple therapy as first‐line treatment for Helicobacter Pylori infection in an area of high resistance to clarithromycin: A prospective, cross‐sectional, comparative, open trial

et al. 2018

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Background Concomitant quadruple (CQT) or bismuth‐containing quadruple therapy (BQT) is recommended as first‐line treatment for Helicobacter pylori infection depending on antibiotic resistance. Aim To compare the efficacy, safety, and compliance of CQT and BQT as first‐line therapy for H. pylori eradication in real clinical practice in an area of high resistance to clarithromycin. Methods A prospective, open, comparative cross‐sectional study including dyspeptic patients >18 years with H. pylori infection and with no previous eradication treatment was performed. CQT (omeprazole 20 mg + clarithromycin 500 mg + amoxicillin 1 g + metronidazole 500 mg, all given twice daily, for 14 days) or BQT (omeprazole 20 mg twice daily + 3 capsules of Pylera® 4 times a day, for 10 days) was prescribed at the discretion of the prescribing physician. Eradication was tested by 13C‐urea breath test. Efficacy was assessed by intention‐to‐treat (ITT) and per‐protocol (PP) analyses. Results One hundred and four consecutive patients were included (64.4% female, age 52.9 years). Fifty patients received CQT and 54 BQT. Eradication rate was similar with both therapies at the PP (CQT 97.9%, 95% CI: 93.9‐100 vs BQT 96.2%, 95% CI: 90.9‐100, P = 0.605) and ITT analyses (CQT 98.0%, 95% CI: 94‐100 vs BQT 94.4%, 95% CI: 88.1‐100, P = 0.346). The rate of adverse events was also similar with CQT (56%) and BQT (46.3%). One patient in each group discontinued the treatment due to significant adverse events. Conclusion The use of CQT and BQT as first‐line treatment against H. pylori is similarly effective and safe strategy in an area of high clarithromycin resistance.

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Section: The Addition Of Certain Probiotics (Different Lactobacillus Andcontrasting

confidence: 58%

Section: The Addition Of Certain Probiotics (Different Lactobacillus Andcontrasting

confidence: 58%

Bismuth‐containing quadruple therapy versus concomitant quadruple therapy as first‐line treatment for Helicobacter Pylori infection in an area of high resistance to clarithromycin: A prospective, cross‐sectional, comparative, open trial

et al. 2018

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“…Recent studies of the comparison of concomitant therapy with sequential therapy in the same period reported the superior efficacy of concomitant therapy . The most important reason for the superior efficacy of concomitant therapy over sequential therapy was that the sequential therapy was less effective in antibiotic‐resistant strains.…”

Section: Discussionmentioning

confidence: 99%

Helicobacter pylori eradication rates of concomitant and sequential therapies in Korea

et al. 2017

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“…Two studies compared ST to concomitant (four drugs: amoxicillin, clarithromycin, metronidazole, and PPI) therapy. A randomised study from Greece showed superior eradication for 10 days of the concomitant regime compared to 10‐day ST (84.6% vs 70.9%) . Another study from Korea looked at a 7‐day concomitant regimen and also found superior rates of eradication compared to the ST (90.3% vs 85.5%) .…”

Section: Sequential Therapymentioning

confidence: 99%

“…A randomised study from Greece showed superior eradication for 10 days of the concomitant regime compared to 10-day ST (84.6% vs 70.9%). 33 Another study from Korea looked at a 7-day concomitant regimen and also found superior rates of eradication compared to the ST (90.3% vs 85.5%). 34 A meta-analysis of randomised studies showed concomitant therapy did not achieve higher eradication rates compared with the ST regimen with…”

Section: Sequential Therapymentioning

confidence: 99%

Treatment of Helicobacter pylori infection 2016

et al. 2016

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Many interesting articles have been published from different parts of the world over the last year assessing various issues around Helicobacter pylori eradication therapy. This article will address the published literature over the last year pertaining to the topic of treatment of H. pylori infection. The main themes that emerge are assessing the efficacy of standard triple therapy, as well as exploring new first-line treatments, mainly optimized nonbismuth-containing and bismuth-containing quadruple therapies with some promising data also emerging on dual therapy. There was also considerable progress in investigating antibiotic resistance rates with much more data emerging from varied parts of the world compared to recent years. Advances in the use of adjunctive therapies, especially probiotic therapies have also been made. Undoubtedly, the eradication of H. pylori remains a worthwhile goal to alleviate the burden of diseases caused by the complications of this infection, including dyspepsia, peptic ulcer disease, and gastric cancer.

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Concomitant versus sequential therapy for the treatment ofHelicobacter pyloriinfection: a Greek randomized prospective study

Abstract: Concomitant therapy led to statistically significant higher eradication rates over sequential therapy. Both therapies showed excellent compliance and an acceptable safety profile. The 10-day quadruple concomitant scheme should be the adopted for first-line H. pylori eradication in Greece.

Cited by 32 publications

References 33 publications

Bismuth‐containing quadruple therapy versus concomitant quadruple therapy as first‐line treatment for Helicobacter Pylori infection in an area of high resistance to clarithromycin: A prospective, cross‐sectional, comparative, open trial

Bismuth‐containing quadruple therapy versus concomitant quadruple therapy as first‐line treatment for Helicobacter Pylori infection in an area of high resistance to clarithromycin: A prospective, cross‐sectional, comparative, open trial

Helicobacter pylori eradication rates of concomitant and sequential therapies in Korea

Treatment of Helicobacter pylori infection 2016

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