Ten and Eight-day Sequential Therapy in Comparison to Standard Triple Therapy for Eradicating Helicobacter pylori Infection

Paoluzi, Omero Alessandro; Visconti, Emanuela; Andrei, Fabio; Tosti, C.; Lionetti, Raffaella; Grasso, E.; Ranaldi, Riccardo; Stroppa, I.; Pallone, Francesco

doi:10.1097/mcg.0b013e3181acebef

Cited by 63 publications

(49 citation statements)

References 34 publications

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“…Fischbach and Evans, in their meta-analysis including more than 10 000 patients demonstrated that in obtaining a high rate of H. pylori eradication the most important role is played by H. pylori resistance to clarithromycin and next to metronidazole [14]. Similar results were obtained by other authors [11,16,25,26]. Wu et al evaluated efficacy of sequential therapy and concomitant treatment with four drugs for 10 days [11].…”

Section: Discussionsupporting

confidence: 70%

Assessment of Sequential and Standard Triple Therapy in Treatment of Helicobacter pylori Infection in Children Dependent on Bacteria Sensitivity to Antibiotics

Iwańczak¹,

Borys-Iwanicka²,

Biernat³

et al. 2016

Adv Clin Exp Med

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Background. In the last decade a 10-day schema of sequential therapy of Helicobacter pylori infection based on proton pomp inhibitor (PPI), amoxicillin (AMO), clarithromycin (CLA) and metronidazole (MET) has been introduced. Many studies have emphasized greater efficacy of this therapy in comparison to the efficacy of the standard 7-day triple therapy (PPI + AMO + CLA or MET). Objectives. The aim of the study was to assess the sequential and standard triple therapy. Material and Methods. Sixty-nine children, aged 5 to 17 years, with symptoms of dyspepsia and gastric or duodenal ulcer were included in the study. The children were randomly divided into three groups. Group I -23 children treated with PPI + AMO + CLA, group II -23 children treated with PPI + AMO + MET, and group III -23 children treated with sequential therapy. The diagnosis of Helicobacter pylori infection was based on histopathological evaluation of gastric mucosa sample and on culture. The sensitivity of bacterial strains to antibiotics was assessed based on E-tests. The efficacy of Helicobacter pylori eradication was assessed 6-8 weeks after the completion of the treatment. Results. In children infected with Helicobacter pylori strains, which were sensitive to clarithromycin, the highest rate of eradication was obtained in the group treated with PPI + AMO + CLA (100%) and in the group treated with sequential therapy (90.48%), the lowest was in the group treated with PPI + AMO + MET. Conclusions. Efficiency of treatment of Helicobacter pylori infection in children depended on sensitivity of the strains to clarithromycin. Sensitivity to metronidazole did not influence significantly the eradication rate (Adv Clin Exp Med 2016, 25, 4, 701-708).

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Section: Discussionsupporting

confidence: 70%

Assessment of Sequential and Standard Triple Therapy in Treatment of Helicobacter pylori Infection in Children Dependent on Bacteria Sensitivity to Antibiotics

Iwańczak¹,

Borys-Iwanicka²,

Biernat³

et al. 2016

Adv Clin Exp Med

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“…Eradication rates of first-line standard therapy reduced from 90% to less than 70-80% (5)(6)(7)(8)(14)(15)(16). Especially resistance to clarithromycin plays a crucial role in the development of inadequate eradication rates and decreases the eradication rates to as low as 70% (17).…”

Section: Discussionmentioning

confidence: 99%

Assessment of Helicobacter pylori eradication rate of triple combination therapy containing levofloxacin

Seven¹,

Çınar²,

Yakut³

et al. 2011

Turk J Gastroenterol

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“…[37][38][39] A meta-analysis suggested that sequential therapy appears to be superior to standard triple therapy even in patients infected with clarithromycin resistant strains. 39 Another meta-analysis showed that, although sequential treatment offered an advantage when compared to standard triple therapy, it cannot be considered a valid alternative.…”

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confidence: 99%

A Pilot Study ofHelicobacter pyloriEradication Using a Polymerase Chain Reaction-based Test for Clarithromycin Resistance

Jung

Kim

Chung

2017

Korean J Helicobacter Up Gastrointest Res

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Background/Aims: Clarithromycin resistance is one of the main predictors of eradication treatment failures in Helicobacter pylori infections. The aim of this study was to investigate the ideal eradication rate of more than 90% of tailored therapies using a polymerase chain reaction (PCR)-based test for clarithromycin resistance in patients with peptic ulcer disease. In addition, we evaluated the possibility of sequential therapies for infections due to clarithromycin-resistant strains. Materials and Methods: We prospectively enrolled patients referred to the gastroenterology unit for the evaluation and management of peptic ulcer from January 2012 to January 2014. Histology, a rapid urease test, and a dual-priming oligonucleotide-based multiplex (DPO)-PCR test were performed on gastric biopsy specimens. In the absence of 23S rRNA point mutations in H. pylori, the patients were treated with standard triple therapy, while in the presence of 23S rRNA point mutations, they were treated with sequential therapies. Results: A total of 93 patients had peptic ulcer disease that was associated with H. pylori infections. These patients received eradication therapies, and 78 patients completed the therapies. The total eradication rate was 91% per protocol analysis, whereas it was 78.3% in patients treated with sequential therapies. Conclusions: The eradication rate of H. pylori with tailored therapies using the DPO-PCR test was acceptable. However, sequential therapies were not effective in patients who did not respond to clarithromycin.

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Ten and Eight-day Sequential Therapy in Comparison to Standard Triple Therapy for Eradicating Helicobacter pylori Infection

Cited by 63 publications

References 34 publications

Assessment of Sequential and Standard Triple Therapy in Treatment of Helicobacter pylori Infection in Children Dependent on Bacteria Sensitivity to Antibiotics

Assessment of Sequential and Standard Triple Therapy in Treatment of Helicobacter pylori Infection in Children Dependent on Bacteria Sensitivity to Antibiotics

Assessment of Helicobacter pylori eradication rate of triple combination therapy containing levofloxacin

A Pilot Study ofHelicobacter pyloriEradication Using a Polymerase Chain Reaction-based Test for Clarithromycin Resistance

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