Twenty-four studies (n=2,342) were included in the review of efficacy, of which 6 (n=862) were included in the meta-analysis.
Ulcer healing with 7-day combination of a PPI plus two antibiotics.
The overall ulcer healing rate was 86% (95% CI: 84, 87), based on 2,342 patients in 24 studies. Ulcer healing in patients with H. pylori eradication success was 95% (95% CI: 94, 96), based on 1,327 patients in 17 studies. Similar results were shown when the analysis was based on studies of patients with duodenal ulcer only, and on studies of patients with duodenal and/or gastric ulcer disease.
Prolongation of PPI therapy following 7-day PPI plus two antibiotics.
One study scored 5 for methodological quality, 4 studies scored 4 and 1 study scored 3 out of a maximum of 5. Five studies were double-blinded.
No statistically significant difference was shown on the likelihood of ulcer healing between the 7-day combination of PPI and prolonged PPI (OR 1.11, 95% CI: 0.71, 1.74, p=0.66). There was no evidence of statistical heterogeneity (p=0.98). Similar results were shown when the analysis was based on studies of higher methodological quality only (quality score of 3 or more) and on studies of patients with duodenal ulcer only.