The global challenge of Helicobacter pylori (H. pylori) cure persists amid rising antimicrobial resistance. Optimizing sequential therapy, particularly with new-generation proton-pump inhibitors (PPIs), offers an effective and cost-efficient treatment.
Utilizing an optimized sequential regimen for 14 days with Rabeprazole can achieve comparable eradication rates to non-bismuth quadruple concomitant therapy, with fewer adverse events and greater cost-effectiveness.
The global challenge of Helicobacter pylori (H. pylori) cure persists amid rising antimicrobial resistance. Optimizing sequential therapy, particularly with new-generation proton-pump inhibitors (PPIs), offers an effective and cost-efficient treatment.
To compare the effectiveness, adverse event rates, and cost of an optimized sequential therapy and standard non-bismuth quadruple treatment lasting 10 and 14 days.
In this prospective open-label study, 328 patients diagnosed with H. pylori infection were randomized to 3 groups (1:1:1):
Adverse events were recorded throughout the study. A 13C urea breath test was used to determine the H. pylori infection eradication rate about 4 to 6 weeks after the treatment.
The H. pylori eradication rate was higher in the OST-14 group (93.5%, 85.5% P = 0.04) than QT-10 group (96.2%, 89.5% P = 0.03) in the intention-to-treat and per-protocol analysis. On the other hand, no statistically noteworthy difference in eradication rates between the second and third groups was found. Patients in the OST-14 group had considerably fewer adverse events and was the most cost-effective therapy among the three.
The optimized 14-day sequential therapy is a safe and efficacious alternative, exhibiting eradication rates comparable to 14-day concomitant therapy.
World Journal of Gastroenterology
Optimized sequential therapy vs 10- and 14-d concomitant therapy for eradicating Helicobacter pylori: A randomized clinical trial
Hassan Seddick et al.
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