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document
Concomitant , sequential , and hybrid therapy for H. pylori eradication : a pilot study . BACKGROUND AND OBJECTIVE Since the efficacy of the standard triple therapies for Helicobacter pylori eradication has decreased , novel antibiotic regimens have been introduced , including concomitant , sequential , and hybrid therapies . We aimed to compare the cure rates achieved by these new therapy regimens . METHODS This was a multicenter , open-label , pilot study enrolling consecutive non-ulcer dyspepsia patients with H. pylori infection never previously treated for the infection . Patients were randomized to receive one of the following treatments : ( a ) concomitant therapy : omeprazole 20mg , amoxicillin 1g , clarithromycin 500 mg , and tinidazole 500 mg for 5 days ; ( b ) sequential therapy : omeprazole 20mg and amoxicillin 1g for 5 days followed by omeprazole 20mg , clarithromycin 500 mg , and tinidazole 500 mg for 5 days ; ( c ) hybrid therapy : omeprazole 20mg , and amoxicillin 1g for 7 days followed by omeprazole 20mg , amoxicillin 1g , clarithromycin 500 mg , and tinidazole 500 mg , for 7 days . All drugs were administered twice daily . Bacterial eradication was checked 6 weeks after treatment by using a ( 13 ) C-urea breath test . A 10-day , second-line therapy with omeprazole 20mg , levofloxacin 250 mg , and amoxicillin 1g , all given twice daily , was offered to the eradication failure patients . RESULTS Overall , 270 patients were enrolled , but 13 patients early interrupted treatment due to side effects . At intention-to-treat ( ITT ) and per-protocol analysis ( PP ) , the eradication rates were 85.5 % and 91.6 % with the concomitant regimen , 91.1 % and 92.1 % with the sequential therapy , and 80 % and 85.7 % with the hybrid regimen . Differences were not statistically significant . H. pylori infection was cured in 10 ( 55.6 % ) patients with the second-line regimen . CONCLUSION In our study , both concomitant and sequential therapy , but not hybrid therapy , reached high eradication rates . The success rate of second-line levofloxacin-based triple therapy is decreasing .
59842
Intervention_Pharmacological
novel antibiotic regimens
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Intervention_Educational
including concomitant , sequential
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Intervention_Physical
hybrid therapies
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Intervention_Pharmacological
concomitant therapy : omeprazole
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Intervention_Pharmacological
amoxicillin
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Intervention_Pharmacological
clarithromycin
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Intervention_Pharmacological
tinidazole
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Intervention_Pharmacological
sequential therapy : omeprazole
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Intervention_Pharmacological
amoxicillin
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Intervention_Pharmacological
omeprazole
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Intervention_Pharmacological
clarithromycin
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Intervention_Pharmacological
tinidazole
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Intervention_Pharmacological
hybrid therapy : omeprazole
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Intervention_Pharmacological
amoxicillin
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Intervention_Pharmacological
omeprazole
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Intervention_Pharmacological
amoxicillin
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Intervention_Pharmacological
clarithromycin
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Intervention_Pharmacological
tinidazole
59860
Intervention_Physical
( 13 ) C-urea breath test
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Intervention_Pharmacological
second-line therapy
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Intervention_Pharmacological
omeprazole
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Intervention_Pharmacological
levofloxacin
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Intervention_Pharmacological
amoxicillin
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Intervention_Pharmacological
concomitant regimen
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Intervention_Physical
sequential therapy
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Intervention_Pharmacological
hybrid regimen
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Intervention_Pharmacological
second-line regimen
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Intervention_Pharmacological
concomitant
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Outcome_Other
pylori eradication
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Outcome_Other
cure rates
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Outcome_Physical
Bacterial eradication
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Outcome_Other
eradication rates
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Outcome_Other
pylori infection
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Outcome_Other
cured
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Outcome_Other
eradication rates
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Outcome_Other
success rate
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Participant_Condition
non-ulcer dyspepsia
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Participant_Condition
H. pylori infection
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Participant_Sample-size
270
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Participant_Sample-size
13