Antimicrobial treatment of H. pylori infection - A pooled efficacy analysis of eradication therapies

Abstract

Objective: To evaluate the clinical efficacy of available therapies directed towards Helicobacter pylori eradication. Design: Pooled overall analyses of a limited number of drug combinations regardless of dosage, duration, formulation etc. Subjects: Helicobacter pylori infected patients with or without complications. Interventions: Efficacy data from all studies included in the analysis are transformed to or retained as intention to treat data. Main outcome: Efficacy is presented as proportion of patients cured from the infection. Confidence intervals are enlarged by 1.5 due to the inferior strength of a pooled analysis. Results: Dual therapies are ineffective. Triple therapies cure 70-90% of the patients. Well documented high efficacy is shown for a proton pump inhibitor plus two antimicrobials. Less studied but effective alternatives are ranitidine-bismuth plus two antimicrobials. Conclusion: A proton pump inhibitor plus two antimicrobials is the best validated highly effective type of eradication therapy.