PMID: 8607488Feb 1, 1996Paper

The influence of drug dosage on Helicobacter pylori eradication: a cost-effectiveness analysis

The American Journal of Gastroenterology
G Treiber

Abstract

This review provides an updated overview on Helicobacter pylori (HP) trials, focusing on drug dosage and cost:benefit ratio. Literature review, with analysis of 362 treatments with 13,562 patients. Statistical evaluation demonstrated the following mean HP eradication rates (ER): 11.7% for monotherapy, 50.7% for dual therapy without acid suppression, 59.8% for dual therapy including acid suppression, 78.1% for triple therapy without acid suppression, 77.5% for triple therapy including acid suppression, and 89.1% for multiple combination therapy (differences between all groups, p < 0.001). In dual therapy, omeprazole/amoxicillin or clarithromycin (mean ER 65.9 vs. 67.6%, NS) showed better results than other combinations. Favorable results in triple therapy were achieved by combined bismuth/imidazoles/tetracycline or by omeprazole/imidazoles/amoxicillin or clarithromycin (mean ER 83.4 vs. 83.5% vs. 93%, NS). The best mean eradication rate, 93.5%, was attained with omeprazole/bismuth/imidazoles/tetracycline. Subgroup analysis revealed a significant correlation between the dose/duration of therapy and the ER for most combinations. The best cost:benefit ratio was demonstrated for omeprazole/imidazoles/clarithromycin (triple therapy i...Continue Reading

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