One-Day Quadruple Therapy Compared With 7-Day Triple Therapy for Helicobacter pylori Infection

Lara, Luis F.; Cisneros, G. Andrés; Gurney, Michael A.; Ness, Michael Van; Jarjoura, David; Moauro, Betty; Polen, Ann; Rutecki, Gregory W.; Whittier, Frederick C.

doi:10.1001/archinte.163.17.2079

Cited by 30 publications

(13 citation statements)

References 76 publications

(116 reference statements)

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“…93 Double combinations (PPI + one antibiotic) are efficient only in 32-64% of cases, 88 and this low rate is also true for F: these therapies have now been abandoned. Although 1-day quadruple therapy achieved >80% of eradication in some randomized studies, 94 an F-based combination proved to be inefficient. 48 None of these regimens are included in any consensus.…”

Section: Discussionmentioning

confidence: 99%

Nitrofuran‐based regimens for the eradication of Helicobacter pylori infection

Buzás¹,

Józan

2007

J of Gastro and Hepatol

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Several aspects of Helicobacter pylori eradication have been meta-analyzed; however, nitrofuran-based therapies constitute an exception. The aim of this study was the systematic review and meta-analysis of the effect of furazolidone-and nitrofurantoin-based regimens in the eradication of infection. Studies evaluating the effects of nitrofurans on H. pylori were identified from Medline, EMBASE, the Cochrane Controlled Trials Register and congress abstracts. The studies were classified into groups based on first-, second-and third-line regimens. The pooled eradication rates and combined odd ratios of the individual studies were calculated and compared with the published meta-analysis. The factors influencing the efficiency of the regimens were also analyzed. Side-effects of nitrofuranbased regimens were also analyzed. The pooled eradication rate of primary proton pump inhibitor-based regimens containing furazolidone was 76.3% .2). The odds ratio for furazolidone-based regimens versus standard triple therapies was 2.34 (CI 0.76-3.92). Ranitidine bismuth citrate + furazolidone-based triple regimens were equally efficient (83.5%, CI 74.0-93.0, P = 0.06 versus triple therapies). Schedules including a H2 antagonist + furazolidone + one other antibiotic achieved pooled eradication rates of 79.9% (CI 67.8-89.9, P = 0.04). Bismuth-based triple therapies achieved 84.5% (CI 72.6-93.0, P = 0.002). Primary quadruple regimens containing furazolidone were superior to triple therapies (83.4%, CI 69.7-92.3, P = 0.01). Second-line schedules containing furazolidone obtained eradication rates of 76.1% (CI 66.4-85.0, P = 0.28 versus primary regimens). Third-line 'rescue' therapies were efficient in 65.5% of the cases (CI 56.3-75.5, P = 0.0001). Side-effects of the regimens containing furazolidone were more frequent than in standard therapies (P = 0.02). The combined odds ratio of side-effects for furazolidonebased versus standard therapies was 0.74 (CI 0.32-1.98). The duration of treatment, but not the furazolidone dose, influenced the treatment outcome. Primary triple regimens containing furazolidone are slightly less efficient than the standard primary combinations; primary quadruple regimens were more efficient than triple therapies. Furazolidone is also efficient as a component of second-line or rescue therapies.

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Section: Discussionmentioning

confidence: 99%

Nitrofuran‐based regimens for the eradication of Helicobacter pylori infection

Buzás¹,

Józan

2007

J of Gastro and Hepatol

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“…The management of H. pylori infection is still under deliberation [12][13][14][15] and various therapeutic regimens have been recommended in Europe based on the Maastricht guidelines. 12 Numerous factors may influence the effectiveness of anti-H. pylori therapy apart from the details of treatment regimen.…”

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confidence: 99%

Implications of Oral Helicobacter pylori for the Outcome of its Gastric Eradication Therapy

Cześnikiewicz-Guzik¹,

Loster²,

Bielański³

et al. 2007

Journal of Clinical Gastroenterology

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Background and Aims: Helicobacter pylori (H. pylori) is an important pathogen in gastritis, peptic ulcer and possibly gastric cancer, but several questions remain unanswered. Particularly how the organism is transmitted and what is the relationship between oral presence of H. pylori and the gastric infection. Accordingly, we aimed to characterize the H. pylori in oral cavity and to evaluate its relationship to gastric H. pylori infection.

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“…Controversy surrounds the optimal composition, dosage, and duration of therapies for more acceptable, rapid, and cost-effective eradication of H. pylori infection (Chu et al, 1998). Thus, consideration has been given to the possibility of shortening the treatment time without compromising its eradication efficacy of H. pylori infection, and in some instances (Wong et al, 2001b;Gambaro et al, 2003;Lara et al, 2003;Yang et al, 2003;Giannini et al, 2006), this has achieved equivalent results to those long-term combined protocols.…”

Section: Discussionmentioning

confidence: 99%

Is short-term therapy really sufficient to eradicate Helicobacter pylori infection?

Zhou

Chen

Zhang

et al. 2010

J. Zhejiang Univ. Sci. B

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Abstract:Objective: The aim of our study was to perform a systematic review and meta-analysis of the efficacy of short-term protocols for Helicobacter pylori eradication and to review the safety and adverse profiles of these eradication protocols. Methods: Literatures were located through electronic searches by PubMed, Medline, ISI Web of Knowledge, and Cochrane Library using the relevant terms. Abstracts of important meetings were searched manually in some journal supplements. Additional bibliographies were identified from the reference lists of identified studies. Three independent reviewers systemically identified randomized controlled trials (RCTs) comparing short-duration protocols vs. 7-d proton pump inhibitor (PPI)-based triple protocols, as well as studies reporting eradication rates of short-duration protocols for H. pylori. Summary effect size was calculated as relative risk (RR) and 95% confidence intervals (CI) using Review Manager 4.2, and P<0.05 was defined as statistically significant in all analyses. Results: Among 90 abstracts retrieved, 15 studies were analyzed, including a total of 30 treatment regimens with 1856 subjects. Mean intention-to-treat (ITT) cure rates of 63.2% and 81.3% were achieved with short-term protocols and 7-d PPI-containing protocols, respectively. Per-protocol (PP)-based overall cure rates were 66.6% and 86.1%, respectively. Short-term therapy was inferior to 7-d triple regimen (P<0.00001). After sub-analysis, however, comparing the effects of ≥3-d protocols and 7-d triple protocols, the cumulative ITT RR was 0.95 (P=0.26), and PP RR was 0.95 (P=0.10), without significant heterogeneity. Moreover, slightly fewer adverse-effects were found in short-term protocols. Conclusions: Although more economical, short-duration protocols are inferior to 7-d PPI-based triple protocols with regarding to eradication rate of H. pylori. Protocols of more than 3 d, however, may be equivalent to 7-d protocols.

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One-Day Quadruple Therapy Compared With 7-Day Triple Therapy for Helicobacter pylori Infection

Cited by 30 publications

References 76 publications

Nitrofuran‐based regimens for the eradication of Helicobacter pylori infection

Nitrofuran‐based regimens for the eradication of Helicobacter pylori infection

Implications of Oral Helicobacter pylori for the Outcome of its Gastric Eradication Therapy

Is short-term therapy really sufficient to eradicate Helicobacter pylori infection?

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