Sequential Therapy for Children with Helicobacter pylori in China

As antibiotic resistance to standard proton-pump inhibitor–based triple therapy has increased, sequential therapy with more than one antibiotic has shown promise of superior eradication rates (NEJM JW Gastroenterol Jan 13 2012). To compare efficacies of these different regimens in a population with high prevalence of Helicobacter pylori, investigators in four tertiary referral hospitals in China randomized 360 children with documented H. pylori infection to receive sequential or standard therapies.

Sequential therapy comprised omeprazole plus amoxicillin for 5 days followed by 5 days of omeprazole, clarithromycin, and metronidazole (doses determined by body weight). Standard triple therapy comprised omeprazole, amoxicillin, and clarithromyci…