Pooled analysis of Helicobacter pylori eradication regimes in Asia.
OBJECTIVE
Differences in Helicobacter pylori strains and their resistance to antimicrobials between Asian and Western countries may affect the success in eradicating this bacterium. Our objective was to systematically review the regimens that have been tested in Asia.


METHODS
Data on anti-H. pylori therapies reported from Asia in a large number of publications identified up to December 1998 were pooled into a few groups based on the combination of drugs used. A comparison of different groups was made by calculating the pooled eradication rates.


RESULTS
Seventy-three studies with 134 treatment arms were reviewed. Pooled eradication rates of dual, triple and quadruple therapies were 61.0, 86.5 and 93.4%, respectively. Proton pump inhibitor (PPI)-based combinations were more widely used and effective, with overall eradication rates of 90.7% in triple therapy and 93.4% in quadruple therapy. Bismuth combined with tetracycline and metronidazole also showed a high eradication rate of 92.0%.


CONCLUSIONS
Proton pump inhibitor-based triple therapy with either clarithromycin, amoxycillin or metronidazole was one of the most commonly used and effective anti-H. pylori triple therapy regimens in Asia. The classical triple therapy with a bismuth, tetracycline and metronidazole combination has a similar efficacy. The results of anti-H. pylori treatment in Asia are not different from those in Western countries.
Wang
W H
WH
Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Pokfulam.
Wong
B C
BC
Lam
S K
SK
D001208:Asia / Q000453:epidemiology; D001729:Bismuth / Q000627:therapeutic use; D004359:Drug Therapy, Combination / Q000627:therapeutic use*; D016481:Helicobacter Infections / Q000188:drug therapy* / Q000453:epidemiology; D016480:Helicobacter pylori / Q000302:isolation & purification; D006801:Humans; D008795:Metronidazole / Q000627:therapeutic use; D054328:Proton Pump Inhibitors; D013752:Tetracycline / Q000627:therapeutic use; D016896:Treatment Outcome
D054328:Proton Pump Inhibitors; D008795:Metronidazole; D013752:Tetracycline; D001729:Bismuth