{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T21:46:02Z","timestamp":1790891162736,"version":"4.1.0"},"reference-count":36,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2015,6,10]],"date-time":"2015-06-10T00:00:00Z","timestamp":1433894400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Changi General Hospital"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Gastro and Hepatol"],"published-print":{"date-parts":[[2015,7]]},"abstract":"Abstract<\/jats:title>Background and Aim<\/jats:title>Clarithromycin\u2010based triple therapy (TT<\/jats:styled-content>) is the first\u2010line treatment for H<\/jats:styled-content>elicobacter pylori<\/jats:italic> infection in S<\/jats:styled-content>ingapore. There is awareness that TT<\/jats:styled-content> may no longer be effective due to increased clarithromycin resistance rates. Sequential therapy (ST<\/jats:styled-content>) and concomitant therapy (CT<\/jats:styled-content>) are alternative treatment regimens. This study aimed to compare the efficacy of 10\u2010day TT<\/jats:styled-content>, ST<\/jats:styled-content>, and CT<\/jats:styled-content> as first\u2010line treatment for H<\/jats:styled-content>.\u2009pylori<\/jats:italic> infection.<\/jats:p><\/jats:sec>Methods<\/jats:title>A randomized study conducted in a teaching hospital. Patients aged 21 years and older with newly diagnosed H<\/jats:styled-content>.\u2009pylori<\/jats:italic> infection were randomized to 10\u2010day TT<\/jats:styled-content>, ST<\/jats:styled-content>, or CT<\/jats:styled-content>. Treatment outcome was assessed by 13\u2010carbon urea breath test at least 4 weeks after therapy. Intention to treat (ITT<\/jats:styled-content>), modified ITT<\/jats:styled-content> (MITT<\/jats:styled-content>), and per protocol (PP<\/jats:styled-content>) analyses of the eradication rates were performed.<\/jats:p><\/jats:sec>Results<\/jats:title>A total of 462 patients were enrolled (ST<\/jats:styled-content>: 154; TT<\/jats:styled-content> 155; CT<\/jats:styled-content> 153). Patient demographics were similar. Eradication rates for ST<\/jats:styled-content>\u2005versus<\/jats:italic>\u2005TT<\/jats:styled-content>\u2005versus<\/jats:italic> CT: ITT<\/jats:styled-content> analysis: 84.4% versus<\/jats:italic> 83.2% versus<\/jats:italic> 81.7% (P<\/jats:italic>\u2009=\u2009not significant [NS<\/jats:styled-content>]); MITT<\/jats:styled-content> analysis: 90.3% versus<\/jats:italic> 92.1% versus<\/jats:italic> 94.7% (P<\/jats:italic>\u2009=\u2009NS<\/jats:styled-content>); PP<\/jats:styled-content> analysis: 94.1% versus<\/jats:italic> 92.8% versus<\/jats:italic> 95.4% (P<\/jats:italic>\u2009=\u2009NS<\/jats:styled-content>). Antibiotic resistance rates for amoxicillin, clarithromycin, and metronidazole were 4.7%, 17.9%, and 48.1%, respectively. Dual clarithromycin and metronidazole resistance occurred in 7.5%. Dual resistance and lack of compliance were predictors of treatment failure.<\/jats:p><\/jats:sec>Conclusions<\/jats:title>TT<\/jats:styled-content>, ST<\/jats:styled-content>, and CT<\/jats:styled-content> all achieved eradication rates above 80% on ITT<\/jats:styled-content> and above 90% on MITT<\/jats:styled-content> and PP<\/jats:styled-content> analyses. Dual resistance and lack of compliance were predictors of treatment failure (clinicaltrials.gov: NCT02092506).<\/jats:p><\/jats:sec>","DOI":"10.1111\/jgh.12892","type":"journal-article","created":{"date-parts":[[2015,1,16]],"date-time":"2015-01-16T16:59:39Z","timestamp":1421427579000},"page":"1134-1139","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":38,"title":["Ten\u2010day triple therapy versus<\/i> sequential therapy versus<\/i> concomitant therapy as first\u2010line treatment for H<\/scp>elicobacter pylori<\/i> infection"],"prefix":"10.1111","volume":"30","author":[{"given":"Tiing Leong","family":"Ang","sequence":"first","affiliation":[{"name":"Department of Gastroenterology and Hepatology Changi General Hospital Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kwong Ming","family":"Fock","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Changi General Hospital Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mingjun","family":"Song","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Changi General Hospital Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daphne","family":"Ang","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Changi General Hospital Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew Boon Eu","family":"Kwek","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Changi General Hospital Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeannie","family":"Ong","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Changi General Hospital Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica","family":"Tan","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Changi General Hospital Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eng Kiong","family":"Teo","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Changi General Hospital Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Subbiah","family":"Dhamodaran","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Changi General Hospital Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2015,6,10]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1440-1746.2009.06188.x"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1440-1746.2008.05314.x"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1440-1746.2009.05982.x"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1136\/gut.2006.101634"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2036.1999.00535.x"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2036.1999.00471.x"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2036.2000.00691.x"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2009.555"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrgastro.2010.210"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1523-5378.2009.00671.x"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dks407"},{"key":"e_1_2_7_13_1","first-page":"408","article-title":"Validation of 13C\u2010urea breath test for the diagnosis of Helicobacter pylori infection in the Singapore population","volume":"43","author":"Chua TS","year":"2002","journal-title":"Singapore Med. 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