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document
Comparison of 7-day and 14-day proton pump inhibitor-containing triple therapy for Helicobacter pylori eradication : neither treatment duration provides acceptable eradication rate in Korea . BACKGROUND AND AIMS Although triple combination therapy containing a proton pump inhibitor ( PPI ) and two antibiotics is considered as a standard regimen for the first-line anti-Helicobacter pylori treatment , there are still debates on the ideal duration of treatment . The aim of this study was to compare the efficacies of 7-day and 14-day PPI-containing triple therapy . MATERIALS AND METHODS This study was performed in a randomized , multicenter , prospective manner . After upper gastrointestinal endoscopy , H. pylori-infected patients with a gastric ulcer and/or a duodenal ulcer were randomly assigned to a PAC7 group ( omeprazole 20 mg or equivalent dose of other PPIs , amoxicillin 1000 mg , and clarithromycin 500 mg twice daily for 7 days ) or to a PAC14 group ( the same regimen as the PAC7 group but for 14 days ) . H. pylori status was evaluated by ( 13 ) C urea breath test 5 weeks after anti-ulcer treatment completion . RESULTS A total of 598 patients were enrolled ; 337 were randomized to the PAC7 group and 261 to the PAC14 group . The two groups were comparable in terms of baseline characteristics . The eradication rates of the PAC7 group were not inferior to those of the PAC14 group in both intention-to-treat analysis ( 71.2 % vs. 75.5 % ) and per-protocol analysis ( 83.6 % vs. 86.6 % ) . Incidences of adverse events were comparable . CONCLUSIONS Although the 7-day PPI-containing triple anti-H. pylori therapy is not inferior to the 14-day therapy , neither treatment duration provides acceptable eradication rate reaching 90 % in per-protocol analysis . New combination regimen with higher efficacy should be developed as a first-line eradication therapy for H. pylori in Korea .
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Intervention_Physical
7-day and 14-day proton pump inhibitor-containing triple therapy
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Intervention_Physical
triple combination therapy
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Intervention_Pharmacological
proton pump inhibitor ( PPI )
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Intervention_Pharmacological
two antibiotics
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Intervention_Physical
7-day and 14-day PPI-containing triple therapy
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Intervention_Surgical
upper gastrointestinal endoscopy
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Intervention_Pharmacological
PAC7
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Intervention_Pharmacological
omeprazole 20 mg or equivalent dose of other PPIs , amoxicillin 1000 mg , and clarithromycin 500 mg twice daily for 7 days )
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Intervention_Pharmacological
PAC14
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Intervention_Physical
the same regimen as the PAC7 group but for 14 days
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Intervention_Pharmacological
PAC7
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Intervention_Pharmacological
PAC14
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Intervention_Pharmacological
PAC7
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Intervention_Pharmacological
PAC14
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Intervention_Pharmacological
7-day PPI-containing triple anti-H.
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Intervention_Physical
pylori therapy
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Intervention_Other
14-day
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Outcome_Physical
Helicobacter pylori eradication
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Outcome_Other
efficacies
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Outcome_Physical
C urea breath
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Outcome_Adverse-effects
adverse events
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Outcome_Other
eradication rate
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Participant_Condition
Helicobacter pylori eradication
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Participant_Condition
upper gastrointestinal endoscopy
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Participant_Condition
H. pylori-infected
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Participant_Condition
gastric ulcer and/or a duodenal ulcer
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Participant_Sample-size
598
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Participant_Condition
H. pylori