Antimicrobial treatment of H. pylori infection--a pooled efficacy analysis of eradication therapies.
OBJECTIVE
To evaluate the clinical efficacy of available therapies directed towards Helicobacter pylori eradication.


METHODS
Pooled overall analyses of a limited number of drug combinations regardless of dosage, duration, formulation etc.


METHODS
Helicobacter pylori infected patients with or without complications.


METHODS
Efficacy data from all studies included in the analysis are transformed to or retained as intention to treat data.


RESULTS
Efficacy is presented as proportion of patients cured from the infection. Confidence intervals are enlarged by 1.5 due to the inferior strength of a pooled analysis.


RESULTS
Dual therapies are ineffective. Triple therapies cure 70-90% of the patients. Well documented high efficacy is shown for a proton pump inhibitor plus two antimicrobials. Less studied but effective alternatives are ranitidine-bismuth plus two antimicrobials.


CONCLUSIONS
A proton pump inhibitor plus two antimicrobials is the best validated highly effective type of eradication therapy.
Department of Medicine, Länssjukhuset Gävle Sandviken, Sweden.
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D000863:Antacids / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001729:Bismuth / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D004415:Dyspepsia / Q000188:drug therapy / Q000382:microbiology; D016481:Helicobacter Infections / Q000188:drug therapy*; D016480:Helicobacter pylori; D006801:Humans; D015201:Meta-Analysis as Topic; D010437:Peptic Ulcer / Q000188:drug therapy / Q000382:microbiology
D000863:Antacids; D000900:Anti-Bacterial Agents; D001729:Bismuth