MODIFIED SEQUENTIAL THERAPY REGIMEN VERSUS CONVENTIONAL TRIPLE THERAPY FOR HELICOBACTER PYLORI ERADICATION

Background: The eradication rates using a conventional triple therapy for Helicobacter pylori (H. pylori) have declined due to increasing antibiotic resistance worldwide. Aims: To compare the eradication rate of the 10-day sequential therapy for H. pylori infection with that of the 10-day standard triple therapy (PPI based). Material Methods: This was a prospective, randomized hospital based study. A total of 300 patients were randomized into three groups of 100 each. Group A received triple therapy consisting of pantoprazole 40mg twice daily, clarithromycin 500mg twice and amoxicillin 1gm twice daily for 10 days. Group B, received Pantoprazole 40mg twice daily, amoxicillin 1gm twice daily from day 1-5 and pantoprazole 40mg twice daily, clarithromycin 500mg twice daily and Tinidazole 500mg twice daily from day 6 to 10. Group C received same regimen as Group B except Levofloxacin 250mg twice daily replaced clarithromycin for day 6-10 in this group. The pre and post treatment H. pylori status was assessed by rapid urease test (RUT). Successful eradication was confirmed at 4 weeks after completion of treatment. Results: The all 300 patients completed the therapy schemes and the examination result indicated that the H. pylori eradication rate of each group was as follows – 86% Levofloxacin based regimen group, 81% with clarithromycin based sequential therapy and 68% with standard triple therapy. So the overall comparison across the groups predicted significant difference with p < 0.05. Conclusion: The sequential therapy is better than standard triple therapy for eradication of H. pylori infection, especially the therapy scheme used in Group C.