A randomised clinical trial of 10-day concomitant therapy and standard triple therapy for Helicobacter pylori eradication

• Published in: Digestive and liver disease 2014-11, Vol.46 (11), p.980-984
• Main Authors: Heo, Jun, Jeon, Seong Woo, Jung, Jin Tae, Kwon, Joong Goo, Kim, Eun Young, Lee, Dong Wook, Seo, Hyang Eun, Ha, Chang Yoon, Kim, Hyun Jin, Kim, Eun Soo, Park, Kyung Sik, Cho, Kwang Bum, Lee, Si Hyung, Jang, Byung Ik
• Format: Article
• Language: English
• Subjects: Aged; Amoxicillin - administration & dosage; Anti-Bacterial Agents - administration & dosage; Anti-Ulcer Agents - administration & dosage; Chi-Square Distribution; Clarithromycin - administration & dosage; Concomitant therapy; Dose-Response Relationship, Drug; Drug Administration Schedule; Drug Therapy, Combination - standards; Female; Follow-Up Studies; Gastroenterology and Hepatology; Helicobacter; Helicobacter Infections - diagnosis; Helicobacter Infections - drug therapy; Helicobacter pylori - drug effects; Helicobacter pylori - isolation & purification; Humans; Lansoprazole - administration & dosage; Logistic Models; Male; Metronidazole - administration & dosage; Middle Aged; Multivariate Analysis; Prospective Studies; Republic of Korea; Standard therapy; Time Factors; Treatment Outcome
• ISSN: 1590-8658; 1878-3562
• DOI: 10.1016/j.dld.2014.07.018

Abstract Background As a result of increased resistance to antibiotics, Helicobacter pylori eradication rates using standard triple therapy have been declining. Aim To validate the efficacy and tolerability of a concomitant regimen as a first-line treatment for H. pylori infection. Methods A total of 348 naïve H. pylori -infected patients from six hospitals in Korea were randomly assigned to concomitant therapy and standard triple therapy groups. The concomitant regimen consisted of 30 mg of lansoprazole, 1 g of amoxicillin, 500 mg of clarithromycin, and 500 mg of metronidazole, twice daily for 10 days. The standard triple regimen consisted of 30 mg of lansoprazole, 1 g of amoxicillin, and 500 mg of clarithromycin, twice daily for 10 days. Results Concomitant and standard eradication rates were 78.7% (137/174) vs. 70.7% (123/174) by intention-to-treat ( p = 0.084) and 88.7% (133/150) vs. 78.4% (120/153) by per-protocol ( p = 0.016), respectively. The two groups were similar with regard to the incidence of adverse events. Conclusions Although 10-day concomitant therapy was validated as a suboptimal treatment option for the treatment of H. pylori infection, this regimen is expected to be a promising starting point in the development of an optimal treatment regimen for H. pylori infection.