Sequential Therapy - Understanding the Treatment Approach

Sequential therapy is a treatment approach where different medications are given one after another, rather than simultaneously, to achieve the desired therapeutic effect.

Sequential Therapy FAQ

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What is a sequential therapy?

The sequential therapy is a simple dual therapy including a proton pump inhibitor (PPI) plus amoxicillin 1 g (both twice daily) given for the first 5 days followed by a triple therapy including a PPI, clarithromycin 500 mg, and tinidazole (all twice daily) for the remaining 5 days [ Zullo et al. 2007 ].

What is sequence therapy?

Sequential therapy is a two-step, 10-day program consisting of administration of a PPI with amoxicillin for the first 5 days, followed by triple therapy that includes a PPI, clarithromycin and tinidazole for another 5 days. An example regimen would be esomeprazole 20 mg twice daily combined with amoxicillin 1 g twice daily, prescribed for 5 days.

What is the difference between sequential therapy and hybrid therapy?

The complexity of sequential therapy may limit its use. Hybrid therapy, a cross between sequential and concomitant therapies, consists of a PPI and amoxicillin for seven days followed by a PPI, amoxicillin, clarithromycin, and a nitroimidazole for seven days.

Is sequential therapy better than triple therapy?

In the 13 trials covered in the recent meta-analysis, sequential generally, but not always, scored as a good therapy (i.e., >90% eradication or Grades A or B) and it was never inferior to triple therapy. In contrast, triple therapy uniformly scored as a bad therapy (Grade F).

Is sequential therapy an alternative regimen for standard triple therapy?

Therefore, sequential therapy is recently suggested as an alternative regimen for standard triple therapy of which the eradication rate is continuously decreasing all over the world.