Loading...
Triple therapy, consisting of a proton-pump inhibitor (PPI), clarithromycin, and amoxicillin or metronidazole (all given twice daily), is standard treatment for patients with Helicobacter pylori infections. However, rising antibiotic resistance has made triple therapy less effective. Investigators conducted a meta-analysis of 46 randomized trials in which sequential therapy (twice-daily PPI plus amoxicillin for 5 days, followed by 5 days of triple therapy with PPI plus clarithromycin plus metronidazole) was compared with various other treatment regimens. Participants were treatment-naive, H. pylori–positive adults.
In 22 trials (with 5000 patients), sequential therapy was significantly better than 7-day courses of triple therapy (eradication…