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Journal of Clinical Gastroenterology:
doi: 10.1097/MCG.0b013e3182548ad4
ALIMENTARY TRACT: Original Articles

Comparative Study of Helicobacter pylori Eradication Rates With 5-day Quadruple “Concomitant” Therapy and 7-day Standard Triple Therapy

Kim, Seung Young MD, PhD; Lee, Sang Woo MD, PhD; Hyun, Jong Jin MD; Jung, Sung Woo MD, PhD; Koo, Ja Seol MD, PhD; Yim, Hyung Joon MD, PhD; Park, Jong Jae MD, PhD; Chun, Hoon Jai MD, PhD; Choi, Jai Hyun MD, PhD

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Background: Several studies have shown the superiority of concomitant quadruple therapy containing 3 antibiotics over triple therapy for Helicobacter pylori infection. The aim of this study was to compare concomitant quadruple therapy with standard triple therapy for first-line H. pylori eradication.

Methods: A total of 270 patients with proven H. pylori infection were randomly assigned to one of 2 regimens: amoxicillin 1000 mg with clarithromycin 500 mg and lansoprazole 30 mg twice daily for 7 days (triple therapy) or amoxicillin 1000 mg with clarithromycin 500 mg, metronidazole 500 mg, and lansoprazole 30 mg twice daily for 5 days (concomitant therapy). The success of eradication was evaluated 4 to 5 weeks after completion of treatment.

Results: Eradication rates were 86.1% in the triple therapy and 91.4% in the concomitant therapy (per protocol), but the difference was not statistically significant. Mild adverse events were more frequently reported in the concomitant-therapy group (35.6%) than in the triple-therapy group (25.2%) (P=0.09).

Conclusions: Five-day quadruple concomitant therapy eradicated H. pylori in over 90% of patients. Accordingly, concomitant therapy is thought to be a promising alternative to triple therapy as a first-line treatment regimen for H. pylori eradication.

© 2013 Lippincott Williams & Wilkins, Inc.


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