Comparison of the efficacy of six different Helicobacter pylori eradication regimens: greater than or equal to another

Abstract

Objective: This study aimed to compare H. pylori eradication rates of different therapy regimens that are commonly used and investigated. Methods: The study included 210 patients with H. pylori positive nonulcer dyspepsia, who were randomised into 6 groups. Group 1: Rabeprazole 20 mg BID+amoxicillin 1000 mg BID for the first 7 d and rabeprazole 20 mg BID+amoxicillin 1000 mg BID+clarithromycin 500 mg BID+metronidazole 500 mg TID for the second 7 d. Group 2: Rabeprazole 20 mg BID+amoxicillin 1000 mg BID for the first 5 d and rabeprazole 20 mg BID+clarithromycin 500 mg BID+metronidazole 500 mg TID for the second 5 d. Group 3: Rabeprazole 20 mg BID+metranidazole 500 mg TID+tetracycline 500 mg QID+bismuth QID for 14 d. Group 4: Rabeprazole 20 mg BID+clarithromycin 500 mg BID+amoxicillin 1000 mg BID for 14 d. Group 5: Rabeprazole 20 mg BID+amoxicillin 1000 mg BID+clarithromycin 500 mg BID +metronidazole 500 mg TID for 7 d. Group 6: Rabeprazole 20 mg BID+amoxicillin 1000 mg BID +clarithromycin 500 mg BID+metronidazole 500 mg TID for 14 d. Results: H. pylori eradication rates were 65.6%, 68.6%, 56.7%, 51.4%, 65.6% and 62.9% respectively, included in the ITT analysis, and 68.6%, 68.6%, 62.9%, 51.4%, 68.6% and 62.9% respectively, included in the PP analysis for all groups. There was no significant difference between the groups with regard to eradication rates. Conclusion: Although H. pylori eradication rates of hybrid, sequential and concomitant therapy regimens were higher than those of quadruple and standard triple therapy regimens, they were also far from the ideal rate.

Standard Bismuth Quadruple Therapy versus Concomitant Therapy for the First-Line Treatment of Helicobacter pylori Infection: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

“…The electronic search identified 1463 records after duplicates were removed, of which 21 full-text articles were assessed for eligibility. Of the 21 articles, 6 met the criteria for inclusion in the review [8,[21][22][23][24][25]. All studies were published in English, except one publication [25] in Russian that was translated.…”

“…The six included studies involved adult subjects with mean age varying from 37 [21] to 58 [24] years and a proportion of men from 42% [22] to 53% [8]. The total sample size ranged from 70 [22] to 1080 [8] participants.…”

Favorable effects of close telephone follow-up on Helicobacter pylori eradication success

“…Triple eradication treatment with two antibiotics from clarithromycin, amoxicillin or metronidazole and a proton-pump inhibitor was used more commonly in the past. However, antibiotic resistant development, which reduced treatment success years during the recent years, significantly complicates the treatment (3)(4)(5)(6)(7)(8)(9). Besides, there is limited information on HP antibiotic resistance rates to guide the treatment.…”

In Vitro Effects of Vitamins C and E on Helicobacter pylori

“…Helicobacter pylori induces chronic gastritis and peptic ulcer when it colonizes the gastric mucosa. H. pylori also plays a role in the etiology of gastric cancer and mucosa-associated lymphoid tissue (MALT) lymphoma [1][2][3][4][5]. This knowledge has a deep clinical impact with regard to the successful management of H. pylori.…”

“…H. pylori eradication is very difficult in areas where antibiotic resistance is high due to uncontrolled use of antibiotics. In areas with low prevalence of resistance to antibiotics, 7-10 days lasting eradication treatment regimens seem to be sufficient [3][4][5]. However, in Turkey, 14-day treatment duration is recommended due to the high prevalence of antibiotic resistance [5][6].…”