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lüll Review article: one-week clarithromycin triple therapy regimens for eradication of Helicobacter pylori Pipkin GA; Williamson R; Wood JRAliment Pharmacol Ther 1998[Sep]; 12 (9): 823-37BACKGROUND: One-week triple therapies have been endorsed as the treatment regimens of choice for eradication of Helicobacter pylori infection. Those that include clarithromycin appear to be the most effective. AIM: To review reports of triple therapies that include clarithromycin. METHODS: Reports were identified from the literature to May 1998. The variation between study designs prevents a formal meta-analysis. A measure of the relative efficacies of regimens has, however, been gained by comparison and by pooling of intention-to-treat eradication rates. RESULTS: One hundred and ninety-two studies were identified which included 264 treatment arms of a 1-week triple therapy composed of clarithromycin with amoxycillin or a nitroimidazole (metronidazole or tinidazole), and either ranitidine bismuth citrate or a proton pump inhibitor (omeprazole, lansoprazole or pantoprazole). From reports of these studies, an intention-to-treat H. pylori eradication rate could be determined from 210 treatment arms of 151 studies. CONCLUSIONS: There is little to choose between the efficacies of 1-week clarithromycin-based triple therapy eradication regimens. However, those comprising clarithromycin, a nitroimidazole and either ranitidine bismuth citrate or a high dose of omeprazole are, in general, the most effective. Against antibiotic-resistant strains of H. pylori, regimens including ranitidine bismuth citrate may be more effective than those including a proton pump inhibitor.|Anti-Bacterial Agents/administration & dosage/*therapeutic use[MESH]|Anti-Ulcer Agents/therapeutic use[MESH]|Bismuth/therapeutic use[MESH]|Clarithromycin/administration & dosage/*therapeutic use[MESH]|Helicobacter Infections/*drug therapy[MESH]|Helicobacter pylori/*drug effects[MESH]|Humans[MESH]|Proton Pump Inhibitors[MESH]|Ranitidine/analogs & derivatives/therapeutic use[MESH] |