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Problems with the standard triple treatment recommended for Helicobacter pylori eradication therapy include unsatisfactory (less than 80%) eradication rates among children.
Dr Andrea Hania and colleagues from Poland assessed the evidence for sequential therapy compared with triple therapy on H. pylori eradication rates in children.
The Cochrane Library, MEDLINE and EMBASE databases were searched in 2012, with no language restrictions, as were abstracts from major gastroenterology conferences, for randomized controlled trials comparing sequential therapy with standard triple therapy for H. pylori eradication. Additional references were obtained from reviewed articles.  | | 78% experienced eradication with sequential therapy | | Alimentary Pharmacology & Therapeutics |
Authors were contacted for extra information. The research team identified 10 randomized controlled trials involving a total of 857 children aged 3–18 years met the inclusion criteria. Of the 409 patients in the sequential therapy group, 78% experienced eradication compared with 71% in the standard triple therapy group. Sequential therapy was superior to 7-day standard triple therapy, but was not significantly better than 10-day or 14-day triple therapy. There were no significant differences between groups in the risk of adverse effects.
Dr Hania's team concludes, "The pooled evidence suggests that 10-day sequential therapy compared with standard triple therapy may be considered as an option for increasing the eradication rates in children." "However, it is still less than desired."
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