The standard treatment for infection with Helicobacter pylori is the triple therapy: a proton pump

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The standard treatment for infection with Helicobacter pylori is the triple therapy: a proton pump inhibitor (PPI), clarithromycin and amoxicillin or metronidazole. This association, however, reveals less and less effective because of resistance of the bacteria to these antibiotics, for which was conducted a meta-analysis of 46 randomized trials in which a sequential therapy (PPI and amoxicillin twice daily for 5 days followed by 5 days of PPI plus clarithromycin plus metronidazole) was compared with different regimens. All participants had not undergone previous treatment. In 22 studies (5,000 patients) sequential therapy was better than the traditional 7-day triple therapy (eradication rate of 87% versus 72%). In 14 studies (2,750 patients), sequential therapy has achieved better results than the triple therapy prolonged to 10 days (eradication rate of 84% versus dengue symptoms 75%). In 7 studies were, however, similar rates of eradication of sequential therapy and triple therapy prolonged dengue symptoms for 14 days, while in 5 studies, efficacy was similar to the quadruple therapy dengue symptoms containing bismuth and 6 in other studies to the quadruple therapy without bismuth (PPI , amoxicillin, clarithromycin, metronidazole). In patients who presented resistance to clarithromycin or metronidazole during the course of the studies sequential therapy was superior both to 7 days is 10 days of triple therapy.
According to this meta-analysis sequential therapy dengue symptoms is superior to the traditional triple therapy, for which the treatment options for eradicating Helicobacter pylori are basically three: the classical triple therapy lasted for 14 days, the quadruple therapy dengue symptoms or sequential therapy. dengue symptoms
If the test is available for bacterial resistance and Helicobacter Pylori proves resistance to clarithromycin is both to metronidazole, clarithromycin replacement with levofloxacin in the sequential dengue symptoms therapy is the procedure that gets the best results.
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