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Treating H. pylori shorter than one week--a real future perspective?
1Robert Bosch Hospital, Department of Gastroenterology, Stuttgart. gerhard.treiber@medizin.uni-magdeburg.de
Zeitschrift Fur Gastroenterologie
|November 10, 2000
Summary
Short-duration H. pylori eradication therapies show promise. Combining proton pump inhibitors with specific antibiotics like macrolides and imidazoles may be as effective as standard treatments, even with very short durations.
Area of Science:
- Gastroenterology
- Infectious Diseases
- Pharmacology
Background:
- Assessing the impact of short-duration (4-6 days) and very short-duration (<=3 days) H. pylori eradication therapies.
- Evaluating potential cost and side-effect advantages over standard one-week triple therapy.
Purpose of the Study:
- To evaluate the efficacy of different H. pylori eradication regimens with varying antibiotic treatment durations.
- To compare the effectiveness of dual, triple, and quadruple therapies for H. pylori eradication.
Main Methods:
- Literature review of 35 studies.
- Analysis of 51 treatment regimens involving 2177 patients.
Main Results:
- H. pylori eradication rates: 61.3% (dual), 75.2% (triple), 79.4% (quadruple).
- Triple therapies with macrolides and imidazoles achieved 84.1% success.
- Very short (< or = 3 days) durations reduced efficacy for some regimens but not for triple therapy with imidazoles and macrolides.
Conclusions:
- Short-term H. pylori eradication using proton pump inhibitors with macrolides and imidazoles (with/without amoxicillin) may match standard one-week triple therapies, even for durations of 3 days or less.
- Proton pump inhibitors with bismuth, tetracycline, and imidazoles are effective if administered for at least 4 days.