首页   按字顺浏览 期刊浏览 卷期浏览 Omeprazole Plus Antibiotics in the Eradication ofHelicobacter pyloriInfectionA Meta&hyp...
Omeprazole Plus Antibiotics in the Eradication ofHelicobacter pyloriInfectionA Meta‐Regression Analysis of Randomized, Controlled Trials

 

作者: Christopher,   Schmid Gregory,   Whiting Douglas,   Cory Susan,   Ross Thomas,  

 

期刊: American Journal of Therapeutics  (OVID Available online 1999)
卷期: Volume 6, issue 1  

页码: 25-36

 

ISSN:1075-2765

 

年代: 1999

 

出版商: OVID

 

关键词: Helicobacter pylori;treatment;eradication;meta-analysis.

 

数据来源: OVID

 

摘要:

This article presents a meta-regression analysis of published studies of omeprazole plus antibiotics (amoxicillin, clarithromycin, or an imidazole derivative) in the treatment ofHelicobacter pylori. Eligible studies were all randomized, controlled trials published through April 1996 with 10 or more patients receiving omeprazole plus antibiotics for 5 or more days and testing forH. pylorieradication 4 weeks or more after treatment. Probability of eradication was calculated for each treatment arm, and logistic regression was performed using study characteristics as covariates. Seventy-four studies involving 117 treatment arms with 4,769 patients were identified. The eradication rate was 76% for omeprazole plus clarithromycin and 65% for omeprazole plus amoxicillin dual regimens (P< .0001). Eradication rates for triple regimens were 82%, omeprazole plus amoxicillin plus clarithromycin; 83%, omeprazole plus amoxicillin plus imidazole; and 89%, omeprazole plus clarithromycin plus imidazole. In a multiple logistic regression analysis, significant factors were antibiotic, disease, omeprazole dose, and whether treatment was followed by maintenance omeprazole. A systematic overview of the best available evidence suggests that dual therapy with omeprazole plus clarithromycin is superior to omeprazole plus amoxicillin. Triple therapy is better than dual therapy. Treatment works better on ulcers than on nonulcer dyspepsia. Higher doses of omeprazole give better results. Additional trials exploring higher omeprazole doses for varying durations as well as cost, side effects, and compliance trade-offs with efficacy are recommended.

 

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