PMID- 15904473
OWN - NLM
STAT- MEDLINE
DCOM- 20050707
LR  - 20181201
IS  - 1083-4389 (Print)
IS  - 1083-4389 (Linking)
VI  - 10
IP  - 3
DP  - 2005 Jun
TI  - Systematic review and meta-analysis: proton pump inhibitor vs. ranitidine bismuth 
      citrate plus two antibiotics in Helicobacter pylori eradication.
PG  - 157-71
AB  - OBJECTIVE: To systematically review the Helicobacter pylori eradication efficacy 
      with ranitidine bismuth citrate (RBC) and two antibiotics, and to conduct a 
      meta-analysis of randomized clinical trials comparing the efficacy of proton pump 
      inhibitor (PPI) vs. RBC with two antibiotics for 1 week. SELECTION OF STUDIES: 
      Studies evaluating RBC plus two antibiotics were considered. For the 
      meta-analysis, randomized controlled trials comparing PPI vs. RBC plus two 
      antibiotics for 1 week were included. SEARCH STRATEGY: Electronic and manual 
      bibliographical searches. Assessment of study quality and data extraction: 
      Independently done by two reviewers. DATA SYNTHESIS: 'Intention-to-treat' 
      eradication rate. Meta-analysis was performed, combining the odds ratios (OR) of 
      the individual studies. Subanalysis: Depending on the type of antibiotics and the 
      quality of the studies. RESULTS: Mean H. pylori eradication with 7-day 
      RBC-clarithromycin-amoxicillin, RBC-clarithromycin-nitroimidazole, and 
      RBC-amoxicillin-nitroimidazole was 83%, 86%, and 71%, respectively. The 
      meta-analysis showed comparable efficacy with RBC and PPI when they were combined 
      with clarithromycin and amoxicillin (OR = 1.11; 95% CI = 0.88-1.40), or with 
      amoxicillin and metronidazole (OR = 0.92; 95%CI = 0.60-1.41). However, when 
      comparing PPI vs. RBC plus clarithromycin and a nitroimidazole, higher cure rates 
      with RBC than with PPI were demonstrated (OR = 1.65; 95% CI = 1.15-2.37). 
      CONCLUSION: The efficacy of RBC and PPI-based triple regimens were comparable 
      when using the clarithromycin-amoxicillin or the amoxicillin-metronidazole 
      combination. However, RBC seems to have a higher efficacy than PPI when 
      clarithromycin and a nitroimidazole are the antibiotics prescribed. Therefore, if 
      one prefers to use the clarithromycin-nitroimidazole regimen, RBC should be used 
      instead of a PPI.
FAU - Gisbert, Javier P
AU  - Gisbert JP
AD  - Department of Gastroenterology, University Hospital of La Princesa, Madrid, 
      Spain. gisbert@meditex.es
FAU - Gonzalez, Leticia
AU  - Gonzalez L
FAU - Calvet, Xavier
AU  - Calvet X
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Meta-Analysis
PT  - Research Support, Non-U.S. Gov't
PT  - Review
PT  - Systematic Review
PL  - England
TA  - Helicobacter
JT  - Helicobacter
JID - 9605411
RN  - 0 (Anti-Bacterial Agents)
RN  - 0 (Anti-Ulcer Agents)
RN  - 0 (Nitroimidazoles)
RN  - 0 (Proton Pump Inhibitors)
RN  - 7AJ51I17KG (ranitidine bismuth citrate)
RN  - 804826J2HU (Amoxicillin)
RN  - 884KT10YB7 (Ranitidine)
RN  - H1250JIK0A (Clarithromycin)
RN  - U015TT5I8H (Bismuth)
SB  - IM
MH  - Amoxicillin/administration & dosage/therapeutic use
MH  - Anti-Bacterial Agents/administration & dosage/*therapeutic use
MH  - Anti-Ulcer Agents/administration & dosage/*therapeutic use
MH  - Bismuth/administration & dosage/*therapeutic use
MH  - Clarithromycin/administration & dosage/therapeutic use
MH  - Drug Therapy, Combination
MH  - Helicobacter Infections/*drug therapy/microbiology
MH  - Helicobacter pylori/*drug effects
MH  - Humans
MH  - Nitroimidazoles/administration & dosage/therapeutic use
MH  - *Proton Pump Inhibitors
MH  - Randomized Controlled Trials as Topic
MH  - Ranitidine/administration & dosage/*analogs & derivatives/*therapeutic use
RF  - 117
EDAT- 2005/05/21 09:00
MHDA- 2005/07/08 09:00
CRDT- 2005/05/21 09:00
PHST- 2005/05/21 09:00 [pubmed]
PHST- 2005/07/08 09:00 [medline]
PHST- 2005/05/21 09:00 [entrez]
AID - HEL307 [pii]
AID - 10.1111/j.1523-5378.2005.00307.x [doi]
PST - ppublish
SO  - Helicobacter. 2005 Jun;10(3):157-71. doi: 10.1111/j.1523-5378.2005.00307.x.