Background and study aim: Helicobacter pylori bacterium is considered one of the most common pathogens that, ‎grows in the digestive tract and has a tendency to attack the stomach lining. It has been ‎estimated that, H. pylori infection occurs in about 50% of the world's adult population. ‎The present consensus is that, all H. pylori infected persons should be cured unless, ‎there are compelling reasons. This study was designed to compare the efficacy of a ‎new sequential regimen with traditional triple and LOAD therapy for eradication of H ‎pylori in naïve patients and patients with previously failed eradication‎.
Patients and Methods: ‎‎‎ A prospective cohort study was carried out on 240 Helicobacter pylori infected patients ‎who were enrolled from outpatient clinic during the period from September 2017 to ‎December 2020. Selected patients were classified into 4 equal groups [GI=60 naïve ‎patients received traditional triple therapy, GII= 60 naïve patients received a new ‎sequential therapy (14 days moxifloxacin, nitazoxanide and esmoprazole, followed by 14 ‎days dexalanzoprazole, levofloxacin and metronidazole), GIII= 60 retreated patients with ‎LOAD therapy after failed traditional triple therapy and GIV= 60 s retreated patients with ‎a new sequential therapy after failed traditional triple therapy]. All participants were ‎subjected to medical history, general and abdominal examination, laboratory ‎investigations, abdomino-pelvic ultrasonography. All participants were evaluated by H ‎pylori antigen test in stool at time of diagnosis and after 4- 6 weeks of full course ‎regimens‎‎.‎
Results: Eradication rates were significantly higher in GII, GIII and GIV (95.0%,   96.7% and ‎‎88.3%) respectively, in comparison to GI naïve patients (66.7%) who showed the lowest ‎cure rate while, the highest cure rate was in GIII‎‎.
Conclusion: A new quinolones based sequential therapy showed more efficacy and less resistance in ‎eradication of H pylori in naïve patients and patients with previously failed eradication by ‎traditional triple therapy‎‎‎.