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  • Randomized clinical trial comparing 10-day sequential, 7-day concomitant and 7-day standard triple therapies for Helicobacter pylori eradication
    Tepeš, Bojan ...
    Objectives: To compare triple therapy with sequential and concomitant therapies directly in a head-to-head comparison in Helicobacter pylori-infected patients. Design: Patients were allocated ... randomly as follows: a triple therapy with esomeprazole (20%mg), amoxicillin (1000%mg) and clarithromycin (500%mg) twice daily for 7 days; a sequential therapy with 5 days of esomeprazole (20%mg) and amoxicillin (1000%mg) twice daily, followed by 5 days of esomeprazole (20%mg), clarithromycin (500%mg) and metronidazole (400%mg) twice daily; or a concomitant therapy consisting of esomeprazole (20%mg), amoxicillin (1000%mg), clarithromycin (500%mg) and metronidazole (400%mg) twice daily for 7 days. Results: A total of 356 consecutive patients were included. The eradication rates for the triple, sequential and concomitant therapies were 83.6% [95% confidence interval (CI) 76.9-90.4%], 94.2% (95% CI 90.0-98.4%) and 91.7% (95% CI 86.7-96.6%), respectively, in the intention-to-treat population. The differences were significant only between triple and sequential therapies (P=0.01). The primary resistance rates to amoxicillin, clarithromycin and metronidazole were 0.6, 10.5 and 25.9%, respectively. Concomitant therapy was significantly better than triple therapy in cases with clarithromycin resistance (P=0.01). Conclusion: Ten-day sequential therapy was significantly better than 7-day triple therapy in a clinical setting with low rates of clarithromycin and dual resistance. Concomitant therapy was significantly better than standard triple therapy in the subgroup of patients with clarithromycin-resistant strains.
    Source: European journal of gastroenterology & hepatology. - ISSN 0954-691X (Vol. 28, no. 6, Jun. 2016, str. 676-683)
    Type of material - article, component part ; adult, serious
    Publish date - 2016
    Language - english
    COBISS.SI-ID - 33011929
    DOI