Eradication of Helicobacter pylori: an objective assessment of current therapies

Br J Clin Pharmacol. 1997 Mar;43(3):223-43. doi: 10.1046/j.1365-2125.1997.00551.x.


The purpose of the present review was to determine objectively the optimal treatment for the eradication of H. pylori amongst the currently used regimens. A comprehensive literature search provided a data-base relating to the following treatments: dual therapy with an anti-secretory drug plus either amoxycillin or clarithromycin; standard triple therapy, with or without additional anti-secretory drugs; proton pump inhibitor triple therapy; and H2-receptor antagonist triple therapy. Emphasis was placed on intention-to-treat analyses of eradication rates using all of the available evidence. The criteria used to select the optimal treatment were efficacy (eradication rates), frequency of side-effects, simplicity of the regimen (number of tablets per day and duration of treatment) and cost. The analysis showed that proton pump inhibitor triple therapy (that is, a proton pump inhibitor plus any two of amoxycillin, clarithromycin or a nitroimidazole) was the preferred treatment for the eradication of H. pylori. In particular, the 1-week, low-dose regimen with omeprazole plus clarithromycin plus tinidazole produced the highest eradication rates (> 90%) with the lowest frequency of side-effects and at only modest cost.

Publication types

  • Review

MeSH terms

  • Anti-Bacterial Agents / adverse effects
  • Anti-Bacterial Agents / therapeutic use*
  • Drug Resistance, Microbial
  • Drug Therapy, Combination / therapeutic use*
  • Enzyme Inhibitors / adverse effects
  • Enzyme Inhibitors / therapeutic use*
  • Helicobacter Infections / drug therapy*
  • Helicobacter Infections / prevention & control*
  • Helicobacter pylori / drug effects*
  • Humans
  • Macrolides
  • Omeprazole / therapeutic use


  • Anti-Bacterial Agents
  • Enzyme Inhibitors
  • Macrolides
  • Omeprazole