Sequential Therapy Bests Triple Therapy for H. pylori Infection

Most guidelines recommend proton-pump inhibitor (PPI)-based triple therapy for treatment of Helicobacter pylori infection. Unfortunately, increasing drug resistance has resulted in decreased success for such regimens, especially in developed countries.

To test an alternative approach to H. pylori eradication, investigators in South Korea conducted a prospective, single-blind, randomized study in which 409 treatment-naive adults with H. pylori infection received either sequential therapy (pantoprazole 40 mg and amoxicillin 1 g, each twice daily for 5 days, followed by pantoprazole 40 mg, clarithromycin 500 mg, and metronidazole 500 mg) twice daily for the next 5 days or standard triple therapy (pantoprazole 40 mg, amoxicillin 1 g, and clarith…