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Similar efficacy seen in three treatments for H. pylori
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ORLANDO, Fla. — Triple therapy, sequential therapy and concomitant therapy all had similar efficacy at eradicating Helicobacter pylori in Singapore, according to data presented here at Digestive Disease Week.
“H. pylori is a common infection in Singapore, with a seroprevalence rate of 31%,” Tiing Leong Ang, MD, of the department of gastroenterology at Changi General Hospital in Singapore, said during his presentation. “Triple therapy with a proton pump inhibitor, amoxicillin and clarithromycin has been the standard treatment. However, increasing bacterial resistance, especially to clarithromycin, has been reported, and there are concerns that the efficacy of triple therapy has decreased.”
Tiing Leong Ang
Ang and colleagues conducted a prospective randomized controlled study that included 292 patients who were newly diagnosed with H. pylori from December 2011 to February 2013. The patients were randomly assigned to triple therapy (proton pump inhibitor [PPI], 1 g amoxicillin and 500 mg clarithromycin twice daily for 10 days), sequential therapy (PPI and 1 g amoxicillin twice daily for 5 days, followed by PPI, 500 mg clarithromycin and 400 mg metronidazole twice daily for 5 days) or concomitant therapy (PPI, 1 g amoxicillin, 500 mg clarithromycin and 400 mg metronidazole twice daily for 10 days).
Twenty-eight patients dropped out, leaving 91 patients who received sequential therapy, 88 patients who received triple therapy and 85 patients who received concomitant therapy. All of the treatment arms were similar in age, sex, smoking and clinical diagnoses. In both the intention-to-treat and per-protocol analyses, there were no significant differences in treatment success rates between the treatments.
“The treatment outcomes were consistent with the known clarithromycin resistance rates reported previously,” Ang said. “All three regimens had similar efficacy and may be used as first-line treatment for H. pylori eradication in Singapore.”
For more information:
Ang TL. #244. Presented at: Digestive Disease Week; May 18-21, 2013; Orlando, Fla.
Disclosure: Ang reports no relevant financial disclosures.