Triple-Drug Regimen Preferable for Treating H. Pylori

Standard triple-drug regimen better than four-drug in treating H. pylori infection in Latin America

TUESDAY, July 19 (HealthDay News) -- The standard 14-day triple-drug regimen is more effective for treating Helicobacter pylori (H. pylori) infection in Latin America than newer four-drug regimens, according to a study published online July 20 in The Lancet.

E. Robert Greenberg, M.D., of the Southwest Oncology Group Statistical Center -- Cancer Research and Biostatistics in Seattle, and colleagues compared the standard triple-drug regimen for treating H. pylori infection with concomitant and sequential four-drug regimens in seven cities in Latin America. A total of 1,463 patients between the ages of 21 and 65 years who tested positive for H. pylori by a urea breath test between September 2009 and June 2010 were randomly assigned to receive one of the following treatments: standard therapy (14 days of lansoprazole, amoxicillin, and clarithromycin; 488 patients), concomitant therapy (five days of lansoprazole, amoxicillin, clarithromycin, and metronidazole; 489 patients), and sequential therapy (five days of lansoprazole and amoxicillin followed by five days of lansoprazole, clarithromycin, and metronidazole; 486 patients). The primary outcome was the probability of H. pylori eradication, evaluated by urea breath test six to eight weeks after treatment.

The investigators found that the probability of H. pylori eradication with standard therapy was 82.2 percent, which was 8.6 percent higher than that achieved with concomitant therapy (73.6 percent) and 5.6 percent higher than sequential therapy (76.5 percent). Neither the concomitant nor sequential four-drug regimens performed significantly better than the standard therapy in any of the study locations.

"Standard 14-day triple-drug therapy is preferable to five-day concomitant or 10-day sequential four-drug regimens as empiric therapy for H. pylori infection in diverse Latin American populations," the authors write.

One of the study authors disclosed financial ties to the pharmaceutical and medical device industries.

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