Sequential vs. Standard Therapy for H. pylori Infection in China

In many areas of the world, Helicobacter pylori eradication rates with standard triple therapy are decreasing, owing mainly to the increasing prevalence of antibiotic resistance. Several early studies suggested that sequential therapy was more successful than standard continuous therapy, and the Maastricht IV guidelines recommend it in the setting of clarithromycin resistance. Trials conducted in Spain, Korea, and Latin America, however, failed to replicate the positive results seen in Italy and Taiwan.

Now, investigators have randomized 280 patients from four medical centers in China to receive either standard therapy (esomeprazole, amoxicillin, and clarithromycin for 10 days) or sequential therapy (esomeprazole and amoxicillin for 5 days, …