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Sequential Antibiotics May Be Better for Peptic Ulcer

Particularly effective for some antibiotic-resistant strains

WEDNESDAY, April 18 (HealthDay News) -- Four antibiotics given sequentially are more effective than three antibiotics together in eradicating Helicobacter pylori infection in patients with dyspepsia or peptic ulcers, particularly for certain antibiotic-resistant strains, according to a study in the April 17 issue of the Annals of Internal Medicine.

Dino Vaira, M.D., from S. Orsola Hospital in Bologna, Italy, and colleagues randomized 300 patients with dyspepsia or peptic ulcers to a sequential 10-day antibiotic regimen (pantoprazole and amoxicillin twice a day for 5 days, then pantoprazole, clarithromycin, and tinidazole twice a day for 5 days) or the standard 10-day regimen (pantoprazole, clarithromycin, and amoxicillin twice a day).

The researchers found that the sequential regimen was significantly better in eradicating H. pylori infection (89 percent vs. 77 percent) and was significantly more effective in eradicating the infection in patients with clarithromycin-resistant strains (89 percent vs. 29 percent). The two groups had a similar incidence of side effects, according to the study.

"Sequential therapy is statistically significant compared with standard therapy for eradicating H. pylori infection and is statistically significantly more effective in patients with clarithromycin-resistant strains," Vaira and colleagues concluded.

One author of the study was financially compensated by Altana Pharma, makers of pantoprozole.

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