Eradication Rates of 10-day Sequential Therapy for Helicobacter pylori: Results of an 8-year Prospective Study Conducted at a Tertiary Korean Hospital

• Main Authors: Kichul Yoon, Nayoung Kim
• Format: Article
• Language: English
• Published: Jin Publishing & Printing Co. 2019-02-01
• Series: The Korean Journal of Gastroenterology
• Subjects: Helicobacter pylori; Sequential therapy; Intention to treat analysis; Per-protocol analysis
• Online Access: http://www.kjg.or.kr/journal/view.html?doi=10.4166/kjg.2019.73.2.99

Background /Aims: The Helicobacter pylori (H. pylori) eradication rate of standard triple therapy is unsatisfactory in Korea, and sequential therapy (SQT) has been suggested to be a practical first-line alternative regimen. The aim of this prospective study was to document changes in annual eradication rates of SQT. Methods: A total of 983 H. pylori-positive subjects were enrolled from 2010 to 2018 and their data were subjected to intention-to-treat (ITT) and per-protocol (PP) analysis. All subjects received 10-day sequential therapy consisting of 40 mg esomeprazole and 1 g amoxicillin b.i.d for 5 days followed by 40 mg esomeprazole b.i.d, 500 mg clarithromycin b.i.d and 500 mg metronidazole t.i.d for 5 days. The 13C-urea breath test, rapid urease test (CLO test®), and histology were used to confirm eradication. Compliance and side effects were also investigated. Results : ITT and PP eradication rates of SQT were 69.9% (687 of 983) and 87.1% (657 of 754), respectively. The annual eradication rate of ITT remained consistent over the 8-year study period (p for trend=0.167), whereas PP analysis showed the eradication rate increased (p for trend=0.042). The overall adverse event rate for SQT was 41.7% (410 subjects). Conclusions: Despite high antibiotic resistance rates in Korea, the eradication rate of SQT did not decrease over the 8-year study period.