• Hong Sang Oh, Dong Ho Lee, Ji Yeon Seo, Yu Ri Cho, Nayoung Kim, Sook Hyang Jeoung, Jin Wook Kim, Jin Hyeok Hwang, Young Soo Park, Sang Hyub Lee, Cheol Min Shin, Hyun Jin Cho, Hyun Chae Jung, and In Sung Song.
• Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
• J. Gastroenterol. Hepatol. 2012 Mar 1; 27 (3): 504-9.

Background And AimsThe eradication rate of proton pump inhibitor (PPI)-based triple therapy for Helicobacter pylori (H. pylori) infection has decreased, mainly due to increasing antibiotic resistance, especially against clarithromycin. It has been reported that a 10-day sequential strategy can produce good outcomes. The aim of this prospective study was to assess the efficacy of sequential therapy as the first-line treatment for the eradication of H. pylori in Korea.MethodsA total of 116 patients with proven H. pylori infection received 10-day sequential therapy (20 mg rabeprazole and 1 g amoxicillin, twice daily for the first 5 days, followed by 20 mg rabeprazole, 500 mg clarithromycin, and 500 mg metronidazole, twice daily for the remaining 5 days); 130 patients received 7-day triple therapy (20 mg rabeprazole, 500 mg clarithromycin, and 1 g amoxicillin, twice daily for 7 days). Eradication was evaluated by the (13) C-urea breath test, 4 weeks after the completion of treatment. Compliance and adverse events were assessed.ResultsThe eradication rates of 10-day sequential therapy and PPI-based triple therapy were 79.3% (92/116) and 63% (82/130) by intention-to-treat analysis, respectively (P = 0.005), and 81.9% (91/111) and 64.5% (82/127) by per protocol analysis, respectively (P = 0.003). Mild adverse events occurred in both therapy groups (27.5% vs 23.8%), but both treatments were well tolerated.ConclusionThe eradication rate of the 10-day sequential therapy regimen was significantly higher than that of PPI-based triple therapy in the Korean population. Ten-day sequential therapy might be effective as a first-line treatment for H. pylori infection in Korea.© 2011 Journal of Gastroenterology and Hepatology Foundation and Blackwell Publishing Asia Pty Ltd.

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