Sequential versus concomitant therapy for treatment of Helicobacter pylori infection: an updated systematic review and meta-analysis.
Background: Sequential and concomitant therapies are two innovative therapies for Helicobacter pylori ( H. pylori) eradication. However, the comparative efficacy and safety of these treatments are controversial. Therefore, we aimed to conduct an updated systematic review and meta-analysis of studies...
| Publicado en: | European Journal of Clinical Pharmacology Vol. 74; no. 1; pp. 1 - 14 |
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| Autores principales: | , , , , , , , |
| Formato: | research systematic review tables/charts Journal Article |
| Publicado: |
Springer Nature
Jan2018
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=127041375&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 127041375 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00316970 NP9 jtl: European Journal of Clinical Pharmacology issn: 00316970 maglogo: N pubinfo: dt: Jan2018 vid: 74 iid: 1 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 127041375 127041375 144178634 127041375 10.1007/s00228-017-2347-7 127041375 ppf: 1 ppct: 13 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Sequential versus concomitant therapy for treatment of Helicobacter pylori infection: an updated systematic review and meta-analysis. aug: au: Wang, Youhua Zhao, Rulin Wang, Ben Zhao, Qiaoyun Li, Zhen Zhu-ge, Liya Yin, Wenzhu Xie, Yong affil: Department of Gastroenterology , The First Affiliated Hospital of Nanchang University , No. 17 yongwai street Nanchang 330000 China sug: subj: Helicobacter Infections Drug Therapy Metronidazole Therapeutic Use Clarithromycin Therapeutic Use Human Meta Analysis Systematic Review PubMed Embase Cochrane Library Confidence Intervals ab: Background: Sequential and concomitant therapies are two innovative therapies for Helicobacter pylori ( H. pylori) eradication. However, the comparative efficacy and safety of these treatments are controversial. Therefore, we aimed to conduct an updated systematic review and meta-analysis of studies that compared these two treatments. Methods: A search of PubMed, Embase, the Cochrane Library, and Web of Science was carried out. Randomized controlled trials (RCTs) that compared sequential with concomitant therapies were selected for meta-analysis. Results: Twenty RCTs were included in the analysis. The eradication rate of 10-day sequential therapy was superior to that of 5-day concomitant therapy (82.09 versus 77.79%, relative risk (RR) 1.052 (95% confidence interval (CI) 1.004-1.103), P = 0.035)), similar to that of 7-day concomitant therapy (82.40 versus 86.99%, RR 0.959 (95% CI 0.874-1.053), P = 0.382), and inferior to that of 10-day concomitant therapy (78.39 versus 83.32%, RR 0.945 (95% CI 0.907-0.984, P = 0.006); the occurrence of diarrhea was higher in 10-day concomitant therapy than that in 10-day sequential therapy. Compared with the eradication rate of sequential therapy, that of concomitant therapy was higher in metronidazole-resistant strains (RR 0.912 (95% CI 0.844-0.986, P = 0.020)) and strains resistant to metronidazole and clarithromycin (RR 0.542 (95% CI 0.308-0.956, P = 0.035)). Conclusion: The efficacy of concomitant therapy was duration dependent, and 10-day concomitant therapy was superior to 10-day sequential therapy. Compared to sequential therapy, concomitant therapy was more efficacious for metronidazole-resistant strains and metronidazole plus clarithromycin-resistant strains. However, diarrhea was more frequent with concomitant therapy than with sequential therapy. pubtype: Academic Journal doctype: meta analysis research systematic review tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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