One-week therapy with omeprazole (PPI) or ranitidine bismuth citrate (RBC) and two antibiotics for eradication of Helicobacter pylori in duodenal ulcer: A preliminary report

Helicobacter pylori eradication: proton pump inhibitor vs. ranitidine bismuth citrate plus two antibiotics for 1 week—a meta‐analysis of efficacy

“…Twelve studies comparing proton pump inhibitor vs. RBC plus two antibiotics for 1 week and meeting the selection criteria were found 5 –16 . One more study was excluded because there was no clear statement that randomization was performed, and a second study was excluded because it included second‐line eradication treatments for previous failures 17 , .…”

“…18 Nine studies compared proton pump inhibitor vs. RBC plus clarithromycin and amoxycillin, its detailed characteristics being shown in Table 1, and five studies compared proton pump inhibitor vs. RBC plus clarithromycin and a nitroimidazole (Table 2). 5 –16 Two of these studies provided data for the two comparisons 12 , . 13 Four studies were published as journal articles, and eight as abstracts presented at congresses 5 –16…”

“…Therefore, comparative studies are necessary to conclude which triple therapy, with proton pump inhibitor or with RBC, is more effective in H. pylori eradication. Thus, in the present meta‐analysis we have included 12 studies comparing these two drugs, plus two antibiotics for 1 week 5 –16…”

“…Nine studies compared proton pump inhibitor vs. RBC plus clarithromycin and amoxycillin in the present meta‐analysis (Table 1, Figure 1). 5 –13 Mean H. pylori eradication rates with the regimen including RBC was 76.6% (intention‐to‐treat) and 83.3% (per protocol). When a proton pump inhibitor instead of RBC was used, H. pylori eradication was achieved in 73.7% (intention‐to‐treat) and 81% (per protocol) of the cases; these differences are not statistically significant, and thus it cannot be concluded that RBC and a proton pump inhibitor have different efficacy for H. pylori eradication when given with clarithromycin and amoxycillin for 1 week.…”

“…The frequency or the severity of adverse effects reported with proton pump inhibitor and RBC‐based regimens has been similar 6 –8 , . 10 –12 , 15 Nevertheless, one study found side‐effects to be more frequent in the RBC group, although they were mild, mainly including black tongue or black faeces 9 . Finally, cost issues also need to be considered when choosing among different therapies with similar efficacy, RBC being cheaper than proton pump inhibitor therapies in most countries.…”