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Eradication of Helicobacter pylori: an objective assessment of current therapies Penston JG; McColl KEBr J Clin Pharmacol 1997[Mar]; 43 (3): 223-43The purpose of the present review was to determine objectively the optimal treatment for the eradication of H. pylori amongst the currently used regimens. A comprehensive literature search provided a data-base relating to the following treatments: dual therapy with an anti-secretory drug plus either amoxycillin or clarithromycin; standard triple therapy, with or without additional anti-secretory drugs; proton pump inhibitor triple therapy; and H2-receptor antagonist triple therapy. Emphasis was placed on intention-to-treat analyses of eradication rates using all of the available evidence. The criteria used to select the optimal treatment were efficacy (eradication rates), frequency of side-effects, simplicity of the regimen (number of tablets per day and duration of treatment) and cost. The analysis showed that proton pump inhibitor triple therapy (that is, a proton pump inhibitor plus any two of amoxycillin, clarithromycin or a nitroimidazole) was the preferred treatment for the eradication of H. pylori. In particular, the 1-week, low-dose regimen with omeprazole plus clarithromycin plus tinidazole produced the highest eradication rates (> 90%) with the lowest frequency of side-effects and at only modest cost.|Anti-Bacterial Agents/adverse effects/*therapeutic use[MESH]|Drug Resistance, Microbial[MESH]|Drug Therapy, Combination/*therapeutic use[MESH]|Enzyme Inhibitors/adverse effects/*therapeutic use[MESH]|Helicobacter Infections/*drug therapy/*prevention & control[MESH]|Helicobacter pylori/*drug effects[MESH]|Humans[MESH]|Macrolides[MESH]|Omeprazole/therapeutic use[MESH] |
