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World J Gastroenterol. Oct 28, 2014; 20(40): 14527-14536
Published online Oct 28, 2014. doi: 10.3748/wjg.v20.i40.14527
Evidence-based assessment of proton-pump inhibitors in Helicobacter pylori eradication: A systematic review
Vinayak Nagaraja, Guy D Eslick
Vinayak Nagaraja, Guy D Eslick, The Whiteley-Martin Research Centre, Discipline of Surgery, The University of Sydney, Nepean Hospital, Penrith, NSW 2751, Australia
Author contributions: All authors contributed to this work.
Correspondence to: Guy D Eslick, Associate Professor, The Whiteley-Martin Research Centre, Discipline of Surgery, The University of Sydney, Nepean Hospital, Level 5, South Block, PO Box 63, Penrith, NSW 2751, Australia. guy.eslick@sydney.edu.au
Telephone: +61-2-47341373 Fax: +61-2-47343432
Received: October 11, 2013
Revised: May 15, 2014
Accepted: May 23, 2014
Published online: October 28, 2014
Abstract

Peptic ulcer disease continues to be issue especially due to its high prevalence in the developing world. Helicobacter pylori (H. pylori) infection associated duodenal ulcers should undergo eradication therapy. There are many regimens offered for H. pylori eradication which include triple, quadruple, or sequential therapy regimens. The central aim of this systematic review is to evaluate the evidence for H. pylori therapy from a meta-analytical outlook. The consequence of the dose, type of proton-pump inhibitor, and the length of the treatment will be debated. The most important risk factor for eradication failure is resistance to clarithromycin and metronidazole.

Keywords: Helicobacter pylori, Peptic ulcer disease, Systematic review, Proton-pump inhibitors

Core tip: This review will discuss the different traits of treatment regimens for Helicobacter pylori (H. pylori)and will also give an insight about some unconventional and novel treatment strategies from a meta-analytic viewpoint. This review summarizes the recommendations and level of evidence regarding the role of the dose, type of proton-pump inhibitor, and the length of the treatment. The review also discusses the various regimes for second line therapy, sequential therapy and new alternate/adjuvant therapies for H. pylori therapy.