Active Ingredients: Amoxicillin
In all, 1224 patients were treated with the sequential therapy compared with 1227 patients treated with triple therapy lasting 14 days, and the eradication rate reported was 80.
The difference in eradication rates was -0. Because of the heterogeneity, we did subgroup analyses according to country of origin, use of tinidazole in the sequential therapy, type of publication, and proton pump inhibitor used; we did not evaluate risk of bias, as all trials were at high or unclear risk of bias supplementary table D.
We found no statistically significant differences. Data on adverse events were available for four trials. Effect of duration of triple therapies on eradication rate The analysis of the studies comparing triple therapies of different durations with sequential therapy allowed us to evaluate the effect of length of the triple regimens on the eradication rate.
Therapy lasting 14 days eradicated 9. We found no significant difference in eradication rate between therapy lasting seven and 10 days 3. Sequential therapy versus bismuth containing therapies In three studies bismuth containing therapies lasted 14 days, whereas in two trials they had a 10 day duration.
In one of the studies lasting two weeks, furazolidone was given during the first week of treatment.
The pooled relative risk was 1. In all, 546 patients were treated with the sequential therapy compared with 545 patients treated with bismuth containing quadruple therapy, and the eradication rate reported was 86.
The difference in eradication rates was 1. Data on adverse events were available for four studies. Sequential therapy versus non-bismuth quadruple therapy Six studies compared sequential therapy with a non-bismuth containing quadruple therapy regimen sometimes called concomitant therapy, including a proton pump inhibitor, amoxicillin, clarithromycin, and metronidazole.
In all, 1039 patients were treated with sequential therapy compared with 1031 patients treated with concomitant therapy, and the eradication rate reported was 81. The difference in eradication rates was 0.
Because of the heterogeneity, we did subgroup analyses according to country of origin, risk of bias, proton pump inhibitor used, duration of non-bismuth containing quadruple therapy, type of publication, and use of tinidazole in the sequential therapy supplementary table E.
We found a slightly statistically significant effect in favour of sequential therapy in trials conducted in Chile and Costa Rica.
Data not included in meta-analysis Sequential therapy versus levofloxacin based sequential therapy Three studies compared sequential therapy with a modified sequential therapy in which levofloxacin was used instead of the clarithromycin used in the original scheme.