Sequential Therapy or Standard Triple Therapy for Helicobacter pylori Infection
| Autor: | Li Feng, Ruo-ting Men, Li Yang, Mao-yao Wen, Yong-Jun Zhu |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
medicine.medical_specialty
macromolecular substances Cochrane Library Drug Administration Schedule Helicobacter Infections law.invention 03 medical and health sciences 0302 clinical medicine Pharmacotherapy Randomized controlled trial law Clarithromycin Internal medicine medicine Humans Pharmacology (medical) Adverse effect Pharmacology Helicobacter pylori business.industry Amoxicillin Proton Pump Inhibitors General Medicine Confidence interval Tinidazole Anti-Bacterial Agents Regimen 030220 oncology & carcinogenesis Relative risk Drug Therapy Combination 030211 gastroenterology & hepatology business medicine.drug |
| Zdroj: | American Journal of Therapeutics. 23:e880-e893 |
| ISSN: | 1075-2765 |
| DOI: | 10.1097/mjt.0000000000000191 |
| Popis: | The effectiveness of standard triple therapy (STT) for the eradication of Helicobacter pylori has decreased recently. Sequential therapy (SQT) is a new regimen proposed to address this problem. The aim of this study was to compare the efficacy of SQT versus STT for H. pylori eradication. We searched The Cochrane Library, MEDLINE, Web of Science, and EMBASE databases up to July 2014. The risk ratios (RRs) of eradication rate were pooled, with a 95% confidence interval (CI). Thirty-six randomized clinical trials including a total of 10,316 patients met the inclusion criteria. The RR for eradication of H. pylori with SQT compared with STT was 1.14 (95% CI: 1.09-1.17), the eradication rates were 84.1% and 75.1%, respectively. There was significant heterogeneity between trial results (I = 73%; P < 0.00001). Subgroup analyses showed that SQT was superior to both 7- and 10-day STT, but not significantly better than 14-day STT. This superiority existed when patients were treated with either metronidazole or tinidazole. Patients with single clarithromycin-resistant strain showed a greater benefit of SQT over STT (eradication rates 80.9% vs. 40.7%), RR = 1.98 (95% CI: 1.33-2.94). There was no significant difference between groups in terms of the risk of adverse effects. In conclusion, SQT is more efficacious than STT (7 days and 10 days) in the eradication of HP, but the pooled rate seemed suboptimal. Further research is needed to develop more effective therapeutic approaches. Surveillance of resistance rates should be performed to guide treatment. |
| Databáze: | OpenAIRE |
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