A meta-analysis of the success rate of Helicobacter pylori therapy in Canada.
OBJECTIVE
Helicobacter pylori treatment success rates have varied. A systematic review of the success rate of anti- H pylori therapy in Canada was performed.


METHODS
All clinical trials containing Canadian data on the success rate of H pylori treatment were identified using MEDLINE searches, through review of references of retrieved studies and by contacting key investigators. Both randomized and open-label trials were included. Treatment effect size was calculated using a variation of Cochran's Q method.


RESULTS
Seventeen papers met the inclusion criteria. Both triple therapies consisting of a proton pump inhibitor (PPI), clarithromycin and either amoxicillin or metronidazole performed well, achieving a success rate of 84% and 82%, respectively. The cure rate of PPI-amoxicillin + metronidazole was 76%. Quadruple therapy consisting of a PPI, bismuth, metronidazole and tetracycline, given for seven to 10 days, achieved a success rate of 87%.


CONCLUSIONS
Both PPI-based triple therapy and quadruple therapy perform well in Canada for the treatment of H pylori infection.
Rodgers
Christopher
C
Division of Gastroenterology, University of Alberta, Edmonton, Canada.
van Zanten
Sander Veldhuyzen
SV
D000863:Antacids / Q000008:administration & dosage*; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D002170:Canada; D002985:Clinical Protocols; D004359:Drug Therapy, Combination; D017506:H(+)-K(+)-Exchanging ATPase / Q000008:administration & dosage*; D016481:Helicobacter Infections / Q000188:drug therapy*; D016480:Helicobacter pylori; D006801:Humans; D054328:Proton Pump Inhibitors; D016896:Treatment Outcome
D000863:Antacids; D000900:Anti-Bacterial Agents; D054328:Proton Pump Inhibitors; D017506:H(+)-K(+)-Exchanging ATPase