***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: BACKGROUND AND AIM One-week triple therapy for Helicobacter pylori revealed , during these last few years , a decrease in the eradication rate , so that the prolongation of its duration has been proposed . A sequential scheme recently showed very satisfactory results . We performed a prospect i ve r and omised study with the aim of either evaluating whether the triple therapy prolongation may improve its effectiveness and comparing its outcome with that of sequential regimen . PATIENTS AND METHODS Three hundred and forty-two H. pylori positive patients completed the study . They were r and omised to receive one of the following treatments : ( i ) a 7-day triple therapy comprising of rabeprazole ( 20 mg , b.i.d . ) plus clarithromycin ( 500 mg , b.i.d . ) and amoxycillin ( 1 g , b.i.d . ) ; ( ii ) a 10-day triple therapy comprising the same scheme ; ( iii ) a 10-day sequential regimen comprising of rabeprazole ( 20 mg , b.i.d . ) plus amoxycillin ( 1 g , b.i.d . ) for 5 days followed by rabeprazole ( 20 mg , b.i.d . ) plus clarithromycin ( 500 mg , b.i.d . ) and tinidazole ( 500 mg , b.i.d . ) for the next 5 days . Therapeutic results were expressed using both intention-to-treat and per protocol analyses with 95 % confidence intervals . A model of multivariate logistic regression analysis was performed using therapeutic outcome as a dependent variable and including endoscopic finding , smoking habit , age and sex as c and i date s for the model . RESULTS Sequential regimen showed a significant gain in the eradication rate as compared to the 7-day ( P < 0.0001 ) and the 10-day ( P < 0.01 ) triple therapies , respectively . Overall eradication was lower in smokers than in non-smokers , but the difference remained significant only in the 7-day triple therapy ( P < 0.01 ) . Additionally , the overall eradication was higher in peptic ulcer than dyspepsia ( P < 0.01 ) , even if this difference was significant only for both triple therapies . CONCLUSIONS Seven-day triple therapy achieves disappointing eradication rates in dyspeptics and smokers . Prolonging triple therapy to 10 days does not significantly improve the eradication rate . The novel 10-day sequential regimen is more effective and equally tolerated than the 10-day triple therapy Background : Predicting factors for the outcome of conventional Helicobacter pylori triple therapy  have been identified . Of these , the presence of the CagA gene is a strong predictor of successful treatment . Our preliminary data show that this factor becomes irrelevant when sequential therapy is used BACKGROUND AND AIMS The eradication rate of proton pump inhibitor (PPI)-based triple therapy for Helicobacter pylori ( H. pylori ) infection has decreased , mainly due to increasing antibiotic resistance , especially against clarithromycin . It has been reported that a 10-day sequential strategy can produce good outcomes . The aim of this prospect i ve study was to assess the efficacy of sequential therapy as the first-line treatment for the eradication of H. pylori in Korea . METHODS A total of 116 patients with proven H. pylori infection received  10-day sequential therapy ( 20 mg rabeprazole and 1 g amoxicillin , twice daily for the first 5 days , followed by 20 mg rabeprazole , 500 mg clarithromycin , and 500 mg metronidazole , twice daily for the remaining 5 days ) ; 130 patients received  7-day triple therapy ( 20 mg rabeprazole , 500 mg clarithromycin , and 1 g amoxicillin , twice daily for 7 days ) . Eradication was evaluated by the ( 13 ) C-urea breath test , 4 weeks after the completion of treatment . Compliance and adverse events were assessed . RESULTS The eradication rates of 10-day sequential therapy and PPI-based triple therapy were 79.3 % ( 92/116 ) and 63 % ( 82/130 ) by intention-to-treat analysis , respectively ( P = 0.005 ) , and 81.9 % ( 91/111 ) and 64.5 % ( 82/127 ) by per protocol analysis , respectively ( P = 0.003 ) . Mild adverse events occurred in both therapy groups ( 27.5 % vs 23.8 % ) , but both treatments were well tolerated . CONCLUSION The eradication rate of the 10-day sequential therapy regimen was significantly higher than that of PPI-based triple therapy in the Korean population . Ten-day sequential therapy might be effective as a first-line treatment for H. pylori infection in Korea BACKGROUND & AIMS Sequential therapy with a proton pump inhibitor ( PPI ) and amoxicillin followed by a PPI , clarithromycin , and an imidazole agent reportedly have a better rate of curing Helicobacter pylori infection than PPI , amoxicillin , and clarithromycin triple therapy . The concomitant administration of these 4 drugs ( concomitant therapy ) is also an effective treatment strategy . We compared the efficacies of sequential and concomitant therapy and analyzed the effects of antibiotic resistance in patients with H pylori infection . METHODS In a r and omized trial of 232 H pylori-infected patients from 3 hospitals in Kaohsiung , Taiwan , patients were given 10 days of sequential ( n = 115 ) or concomitant ( n = 117 ) therapy . H pylori status was confirmed by endoscopy or urea breath test . RESULTS Intention-to-treat analysis demonstrated similar eradication rates for sequential ( 92.3 % ; 95 % confidence interval [ CI ] , 87.5%-97.1 % ) and concomitant therapy ( 93.0 % ; 95 % CI , 88.3%-97.7%)(P = .83 ) . Per- protocol eradication results were similar for sequential ( 93.1 % ; 95 % CI , 90.7%-95.5 % ) and concomitant therapy ( 93.0 % ; 95 % CI , 88.3%-97.7 % ) ( P = .99 ) . Univariate analysis showed that compliance and resistance to clarithromycin  were independent determinants of eradication . Dual resistance did not influence the level of eradication in the concomitant group , but significantly affected that of the sequential therapy group .  Clarithromycin resistance was less frequent than expected . CONCLUSIONS Sequential or concomitant therapy with a PPI , amoxicillin , clarithromycin , and an imidazole agent are equally effective and safe for eradication of H pylori infection . Resistance to clarithromycin , compliance , and adverse events reduced the level of eradication . Concomitant therapy may be more suitable for patients with dual resistance to antibiotics AIM To compare the effectiveness of st and ard triple , bismuth pectin quadruple and sequential therapies for  Helicobacter pylori ( H. pylori ) eradication  in a r and omized , double-blinded , comparative clinical trial in China . METHODS A total of 215 H. pylori-positive patients were enrolled in the study and r and omly allocated into three groups : group A ( n = 72 ) received a 10-d bismuth pectin quadruple therapy ( 20 mg rabeprazole bid , 1000 mg amoxicillin bid , 100 mg bismuth pectin qid , and 500 mg levofloxacin qd ) ; group B ( n = 72 ) received the sequential therapy ( 20 mg omeprazole bid , 1000 mg amoxicillin bid , in 5 d , followed by 20 mg omeprazole bid , 500 mg tinidazole bid , 500 mg clarithromycin bid , for another 5 d ) ; group C ( n = 71 ) received a st and ard 1-wk triple therapy ( 20 mg omeprazole bid , 1000 mg amoxicillin bid , 500 mg clarithromycin bid ) . After all these treatments , 20 mg omeprazole bid was administrated for 3 wk . H. pylori status was assessed by histology , 13C-urea breath test and rapid urease test at baseline and 4 - 6 wk after completion of treatment . Ulcer cicatrization was assessed by gastroscopy . chi(2 ) test ( P < 0.05 ) was used to compare the eradication rates and ulcer cicatrisation rates among the three groups . RESULTS The eradication rate was 83.33 % ( 60/72 ) in group A , 88.89 % ( 64/72 ) in group B , and 80.56 % ( 58/71 ) in group C. The ulcer cicatrisation rate was 86.44 % ( 51/59 ) in group A , 90.16 % ( 55/61 ) in group B , and 84.91 % ( 45/53 ) in group C. The sequential therapy yielded a higher eradication rate and ulcer cicatrisation rate  than the st and ard triple and bismuth pectin quadruple therapies . Statistically , the eradication rate of group B was significantly different from groups A and C ( P < 0.05 ) , but the difference of ulcer cicatrisation rate and side effects was not statistically significant among the three groups ( P > 0.05 ) . The three protocol s were generally well tolerated . CONCLUSION The sequential therapy has achieved a significantly higher eradication rate , and is a more suitable first-line alternative protocol for anti-H. pylori infection compared with the st and ard triple and bismuth pectin quadruple therapies Helicobacter pylori is the primary cause of peptic ulcer disease and an etiologic agent in the development of gastric cancer . H. pylori infection is curable with regimens of multiple antimicrobial agents , and antimicrobial resistance is a leading cause of treatment failure . The Helicobacter pylori Antimicrobial Resistance Monitoring Program ( HARP ) is a prospect i ve , multicenter U.S. network that tracks national incidence rates of H. pylori antimicrobial resistance . Of 347 clinical H. pylori isolates collected from December 1998 through 2002 , 101 ( 29.1 % ) were resistant to one antimicrobial agent , and 17 ( 5 % ) were resistant to two or more antimicrobial agents . Eighty-seven ( 25.1 % ) isolates were resistant to  metronidazole  , 45 ( 12.9 % ) to  clarithromycin  , and 3 ( 0.9 % ) to  amoxicillin .  On multivariate analysis , black race was the only significant risk factor ( p < 0.01 , hazard ratio 2.04 ) for infection with a resistant H. pylori strain . Formulating pretreatment screening strategies or providing alternative therapeutic regimens for high-risk population s may be important for future clinical practice Background : Helicobacter pylori eradication rates with triple therapies are decreasing , and few data in elderly patients are available . A 10‐day sequential regimen succeeded in curing such H. pylori infection in unselected patients BACKGROUND Whether sequential treatment can replace triple therapy as the st and ard treatment for Helicobacter pylori infection is unknown . We compared the efficacy of sequential treatment for 10 days and 14 days with triple therapy for 14 days in first-line treatment . METHODS For this multicentre , open-label , r and omised trial , we recruited patients ( ≥20 years of age ) with H pylori infection from six centres in Taiwan . Using a computer-generated r and omisation sequence , we r and omly allocated patients ( 1:1:1 ; block sizes of six ) to either sequential treatment ( lansoprazole 30 mg and amoxicillin 1 g for the first 7 days , followed by lansoprazole 30 mg , clarithromycin 500 mg , and metronidazole 500 mg for another 7 days ; with all drugs given twice daily ) for either 10 days ( S-10 ) or 14 days ( S-14 ) , of 14 days of triple therapy ( T-14 ; lansoprazole 30 mg , amoxicillin 1 g , and clarithromycin 500 mg for 14 days ; with all drugs given twice daily ) . Investigators were masked to treatment allocation . Our primary outcome was the eradication rate in first-line treatment by intention-to-treat ( ITT ) and per- protocol ( PP ) analyses . This trial is registered with Clinical Trials.gov , number NCT01042184 . FINDINGS Between Dec 28 , 2009 , and Sept 24 , 2011 , we enrolled 900 patients : 3 
    Output:
    
Conclusions Eradication rates with pre-existing and new therapies for H pylori are suboptimal .