Review of Helicobacter pylori eradication regimens

A large number of different treatment regimens aimed at eradicating Helicobacter pylori have been evaluated and reported. A meta-analysis of the pooled results is reviewed here. The treatment strategies have been grouped into 13 treatment classes. The two dual combination therapies reviewed, omeprazole with amoxycillin or clarithromycin, have been analysed with regard to dose and dosing. In all other groups, the total dose of the drugs, number of doses, duration of therapy, and formulation are not taken into account.

A sensitivity test comparing the effect of different study designs on eradication rates showed that study quality has no conclusive impact on success rates. The two dual therapies, together with the H2-receptor antagonist triple therapies, are less effective than triple therapies with omeprazole. Bismuth-based triple therapies have a mean overall eradication rate of 79%, but are limited by frequent and significant side-effects causing poor drug compliance. Data on lansoprazole triple therapies are almost non-existent, while data on omeprazole triple therapies are extensive and consistently show eradication rates of close to or above 90%.