Ten and eight-day sequential therapy in comparison to standard triple therapy for eradicating helicobacter pylori infection: A randomized controlled study on efficacy and tolerability

Background: Sequential therapy (SQT) is effective in the eradication of Helicobacter pylori and could become an alternative to standard triple therapy (STT). AIM: To compare the efficacy and tolerability of SQT, for either 8 or 10 days, with a 7-day STT. Methods: A total of 270 naive H. pylori-positive patients were randomized to receive: SQT for 8 days (SQT-8, n=90) or 10 days (SQT-10, n=90) including esomeprazole 20mg twice daily (bid) associated with amoxicillin 1000mg bid (early 4 and 5d, respectively), followed by esomeprazole 20mg bid associated with clarithromycin 500mg bid plus tinidazole 500mg bid (last 4 and 5d, respectively); STT (n=90) including esomeprazole 20mg bid plus amoxicillin 1000mg bid and clarithromycin 500mg bid for 7 days. Tolerability was assessed by scoring the severity of symptoms. Results: Eradication rates after SQT-8 and SQT-10 were higher than that of after STT at both intention-to-treat (83% and 86% vs. 66%, P