Sequential therapy for H. pylori eradication.

Helicobacter pylori eradication therapy helps to prevent recurrence of, and re-bleeding from, gastric and duodenal ulcers. It also causes regression of most localised gastric mucosa-associated lymphoid-tissue (MALT) lymphomas. Standard triple therapy (comprising a proton pump inhibitor [PPI] plus two antibacterials) has been used routinely to eradicate H. pylori. However, the effectiveness of this type of regimen has declined over time, mainly due to antibacterial resistance. Consequently, other regimens are being used, and these include sequential therapy (e.g. a PPI plus amoxicillin, followed by a PPI plus two other antibacterials). Here we assess the efficacy and safety of sequential H. pylori eradication therapy.