New data reported in the Annals of Internal Medicine suggest that sequential drug therapy works better – and is less expensive -- than the standard 10-day drug therapy to cure peptic ulcers and gastritis.
The most common way to treat peptic ulcers and gastritis is by eradicating Helicobacter pylori ( H. pylori) from the stomach. H. pylori is found in feces, and ingesting food or water contaminated with H. pylori can result in a lifelong infection that irritates and inflames the stomach and lining and leads to overproduction of gastric acid.
As antibacterial resistance continues to increase, H. pylori is becoming more difficult to combat. Now a study reported in the Annals of Internal Medicine (Volume 146, page 556) suggests that when the standard treatment of 10-day triple-drug therapy fails, sequential therapy might be more effective.
Researchers randomly assigned 300 people with peptic ulcers or gastritis to either the standard 10-day therapy with the proton pump inhibitor pantoprazole (Protonix) and the antibiotics clarithromycin (Biaxin) and amoxicillin or a sequential treatment of five days of Protonix, amoxicillin, and placebo followed by five days of Protonix, Biaxin, and the antibiotic tinidazole (Tindamax). Participants took breath tests to detect the presence of H. pylori four and eight weeks after the treatment ended.
People taking sequential therapy were more likely to have complete eradication of H. pylori -- from 89–93% of the group -- vs. 79% of those taking standard therapy. The researchers aren't sure whether the improved success rate was a result of the order of the medications or the addition of a second antibiotic. But they assert that since sequential therapy is more successful and less expensive than standard therapy, it should be considered as a first-line treatment.
