Hybrid Therapy versus Sequential Therapy for Eradication of : A Randomized Controlled Trial.

Objective: To compare the sequential therapy (ST) with the hybrid therapy (HT) for the eradication of .

Materials And Methods: Patients with peptic ulcer disease and gastritis found to be positive were randomized to HT group who received omeprazole (20 mg bid) and amoxicillin (1 g bid) for 7 days followed by omeprazole (20 mg bid), amoxicillin (1 g bid), clarithromycin (500 mg bid), and metronidazole (400 mg tid) for the next 7 days and ST group who received omeprazole and amoxicillin for 5 days followed by omeprazole, clarithromycin, and metronidazole for the next 5 days. Eradication rate, compliance, and complications were compared.

Results: A total of 120 patients were included, sixty in each group. eradication rate was significantly higher in HT group on intention-to-treat analysis (88.3% [confidence interval (CI) 78.3%-94.8%] vs. 73.3% [CI 61.1%-83.3%]; = 0.037). Per-protocol analysis showed higher eradication rate with HT (93% [CI 83.9%-93.7%] vs. 81.5% [CI 69.5%-90.2%]; = 0.068); however, the difference was insignificant. Compliance and side effects were similar. A complete course of HT costs $10.77, while ST costs only $6.347.

Conclusions: HT achieves significantly higher eradication rate than ST with comparable patient compliance and side effects but at an higher price. However, it can be used in places where ST is ineffective.