A randomised clinical trial of 10-day concomitant therapy and standard triple therapy for Helicobacter pylori eradication

Abstract

BackgroundAs a result of increased resistance to antibiotics, Helicobacter pylori eradication rates using standard triple therapy have been declining. AimTo validate the efficacy and tolerability of a concomitant regimen as a first-line treatment for H. pylori infection. MethodsA total of 348 naïve H. pylori-infected patients from six hospitals in Korea were randomly assigned to concomitant therapy and standard triple therapy groups. The concomitant regimen consisted of 30mg of lansoprazole, 1g of amoxicillin, 500mg of clarithromycin, and 500mg of metronidazole, twice daily for 10 days. The standard triple regimen consisted of 30mg of lansoprazole, 1g of amoxicillin, and 500mg of clarithromycin, twice daily for 10 days. ResultsConcomitant and standard eradication rates were 78.7% (137/174) vs. 70.7% (123/174) by intention-to-treat (p=0.084) and 88.7% (133/150) vs. 78.4% (120/153) by per-protocol (p=0.016), respectively. The two groups were similar with regard to the incidence of adverse events. ConclusionsAlthough 10-day concomitant therapy was validated as a suboptimal treatment option for the treatment of H. pylori infection, this regimen is expected to be a promising starting point in the development of an optimal treatment regimen for H. pylori infection.