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New sequential eradication scheme Helicobacter pylori

Recently there is growing evidence of the ineffectiveness of the standard three-component Helicobacter pylori eradication regimen, in which Italian scientists conducted a study that allowed us to compare the effectiveness of the usual H. pylori eradication regimen and the new sequential treatment regimen.

A prospective multicentre randomized open-label study included 1,049 patients with dyspepsia and Helicobacter pylori infection. Patients randomized to the sequential treatment group received rabeprazole 40 mg / day and amoxicillin 1 g twice daily for the first 5 days. For the next 5 days, patients received 20 mg of rabeprazole 2 times a day, 500 mg of clarithromycin 2 times a day and 500 mg of tinidazole 2 times a day. Patients in the standard treatment group received 20 mg rabeprazole, 500 mg clarithromycin and 1 g amoxicillin twice daily for 7 days.

Infection with H. pylori was assessed by histological examination, rapid urease test and C-urease breath test before treatment and 6 weeks or more after treatment.

The results of the study showed that the frequency of eradication was significantly higher in the sequential therapy group than in the standard therapy group (92% versus 74%, p less than 0.0001). It should be noted that a higher eradication rate in the consecutive treatment group was achieved both in patients with peptic ulcer disease and in patients with non-ulcerative dyspepsia.