• Seung Young Kim, Sang Woo Lee, Jong Jin Hyun, Sung Woo Jung, Ja Seol Koo, Hyung Joon Yim, Jong Jae Park, Hoon Jai Chun, and Jai Hyun Choi.
• Department of Internal Medicine, Division of Gastroenterology and Hepatology, Korea University Ansan Hospital, Korea University College of Medicine, Seoul, Korea.
• J. Clin. Gastroenterol. 2013 Jan 1; 47 (1): 21-4.

BackgroundSeveral studies have shown the superiority of concomitant quadruple therapy containing 3 antibiotics over triple therapy for Helicobacter pylori infection. The aim of this study was to compare concomitant quadruple therapy with standard triple therapy for first-line H. pylori eradication.MethodsA total of 270 patients with proven H. pylori infection were randomly assigned to one of 2 regimens: amoxicillin 1000 mg with clarithromycin 500 mg and lansoprazole 30 mg twice daily for 7 days (triple therapy) or amoxicillin 1000 mg with clarithromycin 500 mg, metronidazole 500 mg, and lansoprazole 30 mg twice daily for 5 days (concomitant therapy). The success of eradication was evaluated 4 to 5 weeks after completion of treatment.ResultsEradication rates were 86.1% in the triple therapy and 91.4% in the concomitant therapy (per protocol), but the difference was not statistically significant. Mild adverse events were more frequently reported in the concomitant-therapy group (35.6%) than in the triple-therapy group (25.2%) (P=0.09).ConclusionsFive-day quadruple concomitant therapy eradicated H. pylori in over 90% of patients. Accordingly, concomitant therapy is thought to be a promising alternative to triple therapy as a first-line treatment regimen for H. pylori eradication.

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