Optimal PPI‐based Triple Therapy for the Cure of Helicobacter pylori Infection: A Single Center Comparison of Four 14‐day Schedules

Abstract

All PPI-based triple therapies tested in this study were effective in curing H. pylori infection; however, P + C + B resulted in rates too low (< 85%) to be recommended. P + C + A and P + A + T resulted in the high cure rates and thus may be considered the treatment of choice.

2‐Week Triple Therapy for Helicobacter pylori Infection is Better Than 1‐Week in Clinical Practice: a Large Prospective Single‐Center Randomized Study

“…It is worthwhile pointing out that eradication rates of 75 and 64%, achieved with the 2-week and 1-week regimens, respectively, according to PP analysis, are lower than those obtained with either 1-or 2-week regimens in three European randomized controlled trials (RCT) in which rates ranging from 87 to 93% were reported [20,26,27]. The trial design could, in part, account for the limited efficacy of the treatment regimens observed in the present study, as controlled double-blind trials are generally associated with better results [28,29].…”

“…At multivariate analysis, none of the pretreatment patient characteristics, that is, age, sex, and smoking habit appeared, in agreement with the two Italian studies [4,32], to be predictive of successful triple therapy. A relative homogeneity of our patients, in terms of age and low frequency (23%) of smokers, could have limited the possibility of detecting predictive factors of H. pylori eradication, as suggested by others [20,27,36]. Some authors [37,38] have reported that the frequency of H. pylori eradication is higher in patients with PUD than in those with NUD, although this evidence has not been confirmed by other investigators, probably on account of the small number of patients studied or the high overall eradication rates, as pointed out by de Boer et al [39].…”

“…The use of clarithromycin, in association with effective acid suppression, has been demonstrated to partially overcome metronidazole resistance, achieving similar eradication rates in the presence of resistant or nonresistant H. pylori strains [18]. Indeed, although the resistance most commonly found is resistance to metronidazole, the similarity between the results achieved with the OAC and OMC regimens [19][20][21][22][23] suggests that it could be clarithromycin resistance that has the greatest negative impact on the H. pylori eradication rate [24]. In fact, a meta-analysis by Fischbach et al [25] revealed that the most effective treatment to overcome the resistance to metronidazole and the increasing resistance to clarithromycin is quadruple PPI-based therapy with bismuth, metronidazole, and tetracycline given as a 10-or 14-day regimen.…”

Meta‐analysis: comparative efficacy of different proton‐pump inhibitors in triple therapy for Helicobacter pylori eradication

“…Thirty‐three studies were initially evaluated for meta‐analysis 12–25 ,. 28–46 Nineteen studies were excluded from further analysis 28–46 . Reasons for exclusion are outlined in Table 1.…”

A systematic comparison of triple therapies for treatment of Helicobacter pylori infection with proton pump inhibitor/ ranitidine bismuth citrate plus clarithromycin and either amoxicillin or a nitroimidazole

“…In case of missing or conflicting data, we tried to contact the authors in order to obtain the necessary data. Fourteen studies were excluded because a prospective, randomized design was lacking; 22 –35 three because the number of patients in the different treatment groups was not mentioned; 36 –38 one because it contained conflicting data; 39 and five studies because there was no clear statement that randomization was performed 40 –44 …”