Effectiveness of Sequential Therapy vs. Standard Triple Therapy for H. pylori in Patients with Gastritis

[rosebl321]

Hello, I was recently diagnosed with H. pylori infection and my doctor mentioned both standard triple therapy (PPI + clarithromycin + amoxicillin) and sequential therapy as treatment options. I’ve read that antibiotic resistance can affect treatment success. Could anyone share recent experiences or clinical insights on which therapy has shown higher eradication rates, particularly for patients with mild gastritis? Are there notable differences in side effects between the two approaches?

[Helico_expert]

Think of these treatments as two different game plans for kicking out H. pylori.

Standard Triple Therapy is the simple, heavy-handed approach. It's like giving the bacteria one big, continuous "knockout punch." You take three strong meds—a stomach acid blocker (PPI) and two antibiotics—all at the same time, every day, usually for a week or two. It's super easy to follow and less likely to confuse you, which is great. The catch is that the bacteria have gotten smart; in a lot of places, they've figured out how to dodge one of those key antibiotics (Clarithromycin), so this single-punch method isn't always as effective as it used to be.

Sequential Therapy is the clever, two-part strategy. It's a bit more complicated, but it aims for a better result. First, for five days, you only take the stomach acid blocker and one antibiotic (Amoxicillin). This is like a pre-game attack designed to smash up the bacteria's defenses and dramatically cut down their numbers. Then, for the next five days, you suddenly switch the antibiotics, keeping the acid blocker but bringing in the other two strong antibiotics (Clarithromycin and Metronidazole). The idea is that the few remaining, weakened bacteria can't handle the new medication combination. Because those stronger antibiotics are only used for half the time, people often find they have fewer uncomfortable side effects with this method, and it tends to be more successful against the resistant bugs.

In short, triple therapy is simple but losing effectiveness, and sequential therapy is a little trickier to follow but often delivers a more reliable win.