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South Med J. 2011 Feb;104(2):102-5. doi: 10.1097/SMJ.0b013e318200c209.

Comparison of two different treatment protocols in Helicobacter pylori eradication.

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  • 1Department of Gastroenterology, Sivas Numune Hospital, and Department of Gastroenterology, Cumhuriyet University, School of Medicine, Sivas, Turkey. nadirislay@yahoo.com.tr



The prevalence of Helicobacter pylori (H pylori) in Turkey is high and eradication rates are low. As a result, alternative treatment strategies are required.


To evaluate the status of H pylori eradication in Turkey by comparing the results of this study to other studies reported in the literature.


Two hundred and eighty-two patients diagnosed with H pylori were included in this study. Patients were randomized into two groups. The first group consisted of 138 patients receiving 30 mg lansoprazole bid, amoxicillin 1 g bid, and clarithromycin 500 mg bid for 14 days. The second group consisted of 144 patients who received lansoprazole 30 mg bid and amoxicillin 1 g bid for seven days, followed by metronidazole 500 mg bid, tetracycline 500 mg qid, and lansoprazole 30 mg bid for an additional seven days.


H pylori eradication rates in the first group were 53.6% according to intention-to-treat analysis, and 52.5% according to per protocol analysis. In the second group, eradication rates were 72.2% per intention-to-treat analysis and 77.6% as per protocol analysis. H pylori eradication rates in the second group were significantly higher than the first group (P=0.001, P<0.05), whereas the incidence of adverse events in the second group was significantly lower (P=0.048, P<0.05).


This study found a significant difference in eradication rates between the traditional triple therapy and modified sequential therapy groups. As a result, modified sequential therapy shows promise as an alternative treatment.

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