Head‐to‐head comparison of 1‐week triple regimens combining ranitidine or omeprazole with two antibiotics to eradicate Helicobacter pylori

Abstract

Omeprazole and ranitidine combined with two antibiotics for 1 week are equally effective in the eradication of H. pylori infection, and these results question the role of profound acid suppression in the eradication of the bacterium.

Guidelines in the Management of Helicobacter pylori Infection in Japan

“…The eradication rates for omeprazole 20 mg plus amoxicillin 1.5 g plus clarithromycin 400 mg were 85.1% (95% CI: 72% to 94%) for 7 days and 82.7% (95%CI: 74% to 90%) for 14 days on an intention‐to‐treat basis, and 88.9% (95% CI: 76% to −96%) for 7 days and 88% (95%CI: 80% to 94%) for 14 days on an per‐protocol basis [82]. Amoxicillin plus clarithromycin combined with an H 2 ‐receptor antagonist (an antisecretory drug) at double the usual dose produced an eradication rate equal to that using a PPI at double the dose [83]. On the subject of dose levels, there has been no report stating that PPIs are preferable as antisecretory agents.…”

“…Adverse effects associated with H. pylori eradication therapy have been reported in 14.8–45.1% of patients [81–85]. Diarrhea and soft stools occur most frequently in about 10% to 30%, followed by dysgeusia, glossitis, and stomatitis in 5–15%, rash in 2–5%.…”

Strategy for Treatment of Helicobacter pylori Infection in Adults II. Practical Policy in 2000

“…For example, some randomized controlled studies showed the same eradication rates between PPIbased and H2RA-based 1-week triple therapies [65,66]. Meta-analytic studies have shown somewhat lower eradication rates in H2RA-based triple therapies than PPI-based triple therapies [33,67].…”

“…Side effects of recent major regimens are shown in Table 6a and b [37,42,66,[74][75][76][77][78][79][80][81][82][83][84]. One should be careful in comparing therapies because the methods for evaluation of the side effects were different among the studies.…”

Comparison of H2-Receptor Antagonist-and Proton-Pump Inhibitor-Based Triple Regimens for the Eradication of Helicobacter Pylori in Chinese Patients with Gastritis or Peptic Ulcer

“…Some studies have compared triple regimens based on the H 2 RA famotidine with those based on PPIs; the results showed that the eradication rates of H. pylori with these two treatments were quite similar. 9 Savarino et al 10 compared the eradication rate of two triple regimens -omeprazole, amoxicillin and metronidazole, and ranitidine, amoxicillin and clarithromycin -in 320 patients with H. pylori; there was no significant difference in the eradication rate of H. pylori for the two treatments.…”