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Triple-Drug Regimen Preferable for Treating H. Pylori

he standard 14-day triple-drug regimen is more effective for treating Helicobacter pylori (H. pylori) infection in Latin America than newer four-drug regimens, according to a study published online July 20 in The Lancet.

E. Robert Greenberg, M.D., of the Southwest Oncology Group Statistical Center -- Cancer Research and Biostatistics in Seattle, and colleagues compared the standard triple-drug regimen for treating H. pylori infection with concomitant and sequential four-drug regimens in seven cities in Latin America. A total of 1,463 patients between the ages of 21 and 65 years who tested positive for H. pylori by a urea breath test between September 2009 and June 2010 were randomly assigned to receive one of the following treatments: standard therapy (14 days of lansoprazole, amoxicillin, and clarithromycin; 488 patients), concomitant therapy (five days of lansoprazole, amoxicillin, clarithromycin, and metronidazole; 489 patients), and sequential therapy (five days of lansoprazole and amoxicillin followed by five days of lansoprazole, clarithromycin, and metronidazole; 486 patients). The primary outcome was the probability of H. pylori eradication, evaluated by urea breath test six to eight weeks after treatment.

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