Subjects and methods: Firty-one patients with duodenal ulcer with H pylori positive were enrolled to a 14-day sequential regimen 40 mg of esomeprazole, 1 g of amoxicillin, each administered twice daily for the first 7 days, followed by 40 mg of esomeprazol, 500 mg of clarithromycin, and 500 mg of metronidazole, each administered twice daily for the remaining 7 days.