The efficacy of sequential therapy in eradication of Helicobacter pylori in Turkey

Abstract

Background and Aim: Most of the studies about sequential therapy that have been reported from Turkey were levofloxacin based. We aimed to compare the Helicobacter pylori (H. pylori) eradication rates of standard triple, sequential and quadruple therapies including claritromycin regimes in this study.

Materials and Methods: A total of 160 patients with dyspeptic symptoms were enrolled to the study. The patients were randomized to four groups of treatment protocols. And 40 patients received standard triple therapy for 2 weeks, 40 patients received bismuth containing quadruple therapy for 2 weeks, 40 patients received 5 + 5 clarithromycin-based sequential therapy, and 40 patients received 7 + 7 clarithromycin-based sequential therapy. H. pylori eradication was assessed by C 14 urea breath test 4 weeks after therapy.

Results: Out of 160 patients with H. pylori infection, 131 (81.9%) were eradicated successfully and 29 (18.1%) failed to eradicate H. pylori infection. H. pylori eradication was achieved in 28 of 40 patients receiving standard triple therapy (70%), in 33 of 40 patients receiving quadruple therapy (82.5%), in 37 of 40 patients receiving 5 + 5 sequential therapy (92.5%), and in 33 of 40 patients receiving 7 + 7 sequential therapy (82. 5%). Statistics revealed that 5 + 5 sequential therapy led to significantly higher H. pylori eradication rates compared with that of standard triple therapy (P = 0.019). There was no statically difference between 5 + 5 sequential therapy and the other therapy groups’ eradication rates, but it was higher than all of the protocols. H. pylori eradication rate with sequential therapy in our patients with nonulcer dyspepsia was higher than those of patients with standard therapy (93% versus 82%, respectively, P>0.05).

Conclusion: 5 + 5 sequential therapy was associated with significantly higher eradication rate of H. pylori compared with standard triple therapy in our study cohort.

Keywords: H.pylori, sequential therapy, eradication protocols