Triple vs. quadruple therapy for treating Helicobacter pylori infection: a meta-analysis.

Abstract:

BACKGROUND:Triple therapy (proton pump inhibitor, clarithromycin and amoxicillin or an imidazole) is the first-line treatment for Helicobacter pylori infection. However, the effectiveness of triple therapy is decreasing due to the increase in antibiotic resistance. Quadruple therapy (proton pump inhibitor, tetracycline, metronidazole and a bismuth salt) is a very effective regimen even in areas of high prevalence of antibiotic resistance, and may be an alternative first-line treatment. AIM:To compare triple vs. quadruple therapy for the first-line treatment of H. pylori infection. METHODS:An extensive literature search was performed to identify randomized trials comparing triple vs. quadruple therapy. Selected trials were included in a meta-analysis using Review Manager 4.1. RESULTS:Four studies met the inclusion criteria. Eradication rates with quadruple therapy were slightly higher in both the intention-to-treat (81% vs. 78%; odds ratio, 0.83; 95% confidence interval, 0.61-1.14) and per protocol (88% vs. 85%; odds ratio, 0.81; 95% confidence interval, 0.55-1.20) analysis, although the differences were not statistically significant. Nor were there significant differences in compliance or adverse effects between the therapies. CONCLUSION:Triple and quadruple therapies seem to be roughly equivalent in terms of effectiveness, compliance and side-effects profile when administered as first-line treatment for H. pylori infection.

journal_name

Aliment Pharmacol Ther

authors

Gené E,Calvet X,Azagra R,Gisbert JP

doi

10.1046/j.1365-2036.2003.01566.x

subject

Has Abstract

pub_date

2003-05-01 00:00:00

pages

1137-43

issue

9

eissn

0269-2813

issn

1365-2036

pii

1566

journal_volume

17

pub_type

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