Acta Med. 2020, 63: 183-187

Comparing the Efficacy of Sequential and Standard Quadruple Therapy for Eradication of H. Pylori Infection

Mohsen Razavizadeh, Abbas Arj, Maryam Madani, Hamidreza Gilassi

Department of Internal Medicine, Faculty of Medicine, Kashan University of Medical Sciences, Kashan, Iran

Received January 17, 2020
Accepted September 13, 2020

Background: The aim of this study was comparison the effectiveness of sequential and standard quadruple therapy on eradication of H. pylori infection. Methods: This clinical trial study was conducted on 160 patients with dyspepsia or gastroduodenal ulcer. Patients were randomly divided into two groups. Group A (standard regimen) received omeprazole, amoxicillin, clarithromycin and bismuth subcitrate for 2 weeks. Group B (sequential regimen) received omeprazole and amoxicillin in 5 days and omeprazole, tinidazole and levofloxacin in 5 days. After the end of treatment regimens, 20 mg omeprazole was administered twice daily for 3 weeks. H. pylori eradication was assessed 2 months after antibiotic treatment via fecal antigen. Results: Frequency of H. pylori eradication in group A and B was observed in 55 (68.8%) and 63 patients (78.8%), respectively. No significant difference was seen between two groups, regarding H. pylori eradication (p = 0.15). The most common side effects in group A, B were bitterness of mouth (63.8%) and nausea (16.2%), respectively (p < 0.001). Conclusion: Although no significant difference was seen between two groups regarding eradication of H. pylori infection, higher rate of H. pylori eradication was seen in group B than group A. Thus, sequential regimen was a more appropriate regimen with fewer complications.


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