Sequential therapy for H. pylori: an “aberrant” therapy ready for general use.

none8Sir, We read with great interest the comprehensive commentary by de Boer et al. regarding the use of sequential therapy for Helicobacter pylori eradication [1]. However, we do not understand why the authors should ‘scientifically be warred’ regarding the possibility to find out a better eradication regimen, whichever it is and wherever does it came. We do think the following comments could be useful to the authors as well as to the readers of the Journal. It has been stated that ‘presently, only quadruple therapy qualifies to replace PPI-triple regimen as first-line therapy’. Unfortunately, this opinion does not seem to be supported by available data. On the contrary, a meta-analysis including five well-designed, ‘head-to-head’ comparison studies failed to find a signifi- cant difference in the success rate between 7-day quadruple and triple therapies, bacterial infection being cured in 449 of 559 (80%; 95% CI: 77–84), and in 451 of 569 (79%; 95% CI: 74–81) patients, respectivelynonenoneZullo A; Hassan C; Morini S; De Francesco V; Ierardi E; Panella C; Gatta L; Vaira DZullo A; Hassan C; Morini S; De Francesco V; Ierardi E; Panella C; Gatta L; Vaira