Objective: The aim of this study was to assess and compare the efficacy and safety of sequentialtreatment with standard triple therapies in a located population in Morocco.Methods: Consecutive H. pylori-positive patients with endoscopy-proven ulcer or non ulcer dys-pepsia were prospectively randomized in the trial into one of three groups: AM and AC groupwere administered a tri-therapy for 7 days including PPI + amoxicillin + metronidazole (AMgroup)/clarithromycin (AC group) and SQ group was administered a sequential regimen con-sisting of PPI + amoxicillin for 5 days followed by PPI + clarithromycin + metronidazole for theremaining 5 days. Eradication was confirmed by 13C-urea breath test 3 months after the end ofthe treatment.Results: Groups AM, AC and SQ included respectively 104, 115 and 104 patients. They werecomparable in terms of age, sex, clinical and endoscopic presentation. The rate of H. pylorieradication with sequential therapy was found at 94.2% (n = 98) in ITT and 96% (n = 98) in PP. Itwas higher than those found in the AM group: 70% (n = 73) in ITT and 70.8% (n = 73) in PP and theAC group: 78.2% (n = 90) in ITT and 79.6% (n = 90) in PP (0.001). The prevalence of side effectsfollowing the sequential treatment was 9.6% (n = 10) versus 22% (n = 22) and 27.8% (n = 32) inthe AM and AC groups, respectively, (P = 0.006).Conclusions: Sequential treatment was better tolerated and achieved a significantly highereradication rate of H. pylori compared with standard triple therapies in this population