Document Detail


Helicobacter pylori eradication: proton pump inhibitor vs. ranitidine bismuth citrate plus two antibiotics for 1 week-a meta-analysis of efficacy.
MedLine Citation:
PMID:  10971230     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To compare the efficacy of proton pump inhibitor vs. ranitidine bismuth citrate (RBC) with two antibiotics for 1 week in Helicobacter pylori eradication. METHODS: Randomized trials comparing 1-week regimens with (i) proton pump inhibitor plus two antibiotics [clarithromycin (C) and amoxycillin (A) or a nitroimidazole (N)]; or (ii) RBC plus the same antibiotics. Eradication was confirmed by histology or 13C-urea breath test at least 4 weeks after therapy. Data sources included PubMed database and abstracts from congresses until October 1999. Statistical analysis was by meta-analysis combining the odds ratios (OR) of the individual studies in a global OR (Peto method). RESULTS: Twelve studies met the selection criteria. Nine compared proton pump inhibitor vs. RBC plus C and A, and five compared proton pump inhibitor vs. RBC plus C and N. With RBC, C and A, mean H. pylori eradication efficacy by intention-to-treat analysis (pooled data) was 76.6% (95% CI: 72-81%) and 73.7% (95% CI: 69-78%) with proton pump inhibitor, C and A. The OR for the effect of RBC vs. proton pump inhibitor (plus C and A) on H. pylori eradication was 1.15 (95% CI: 0.8-1.64%). Mean H. pylori eradication with RBC, C and N was 87. 2% (95% CI: 83-91%), and 74.9% (95% CI: 74-84%) with proton pump inhibitor plus these two antibiotics. The OR for the effect of RBC vs. proton pump inhibitor (plus C and N) on H. pylori eradication was 1.76 (95% CI: 1.08-2.85%). CONCLUSION: RBC and proton pump inhibitor have similar efficacy for H. pylori eradication when given with C and A for 1 week, but RBC seems to have a higher efficacy than proton pump inhibitor when C and N are the co-prescribed antibiotics.
Authors:
J P Gisbert; L González; X Calvet; M Roqué; R Gabriel; J M Pajares
Publication Detail:
Type:  Journal Article; Meta-Analysis; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Alimentary pharmacology & therapeutics     Volume:  14     ISSN:  0269-2813     ISO Abbreviation:  Aliment. Pharmacol. Ther.     Publication Date:  2000 Sep 
Date Detail:
Created Date:  2000-10-19     Completed Date:  2000-10-19     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8707234     Medline TA:  Aliment Pharmacol Ther     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  1141-50     Citation Subset:  IM    
Affiliation:
Department of Gastroenterology, University Hospital of 'La Princesa', Madrid, Spain. gisbert@meditex.es
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MeSH Terms
Descriptor/Qualifier:
Amoxicillin / administration & dosage,  therapeutic use*
Anti-Bacterial Agents / administration & dosage,  therapeutic use*
Anti-Ulcer Agents / administration & dosage,  therapeutic use*
Bismuth / administration & dosage,  therapeutic use*
Clarithromycin / administration & dosage,  therapeutic use*
Drug Therapy, Combination
Helicobacter Infections / drug therapy*
Helicobacter pylori / drug effects*
Humans
Nitroimidazoles / administration & dosage,  therapeutic use*
Proton Pumps / antagonists & inhibitors*
Randomized Controlled Trials as Topic
Ranitidine / administration & dosage,  analogs & derivatives*,  therapeutic use
Chemical
Reg. No./Substance:
0/Anti-Bacterial Agents; 0/Anti-Ulcer Agents; 0/Nitroimidazoles; 0/Proton Pumps; 128345-62-0/ranitidine bismuth citrate; 26787-78-0/Amoxicillin; 66357-35-5/Ranitidine; 7440-69-9/Bismuth; 81103-11-9/Clarithromycin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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