A systematic review and meta-analysis published in Current Reviews in Clinical and Experimental Pharmacology recommended omeprazole, amoxicillin, and clarithromycin/metronidazole [PPIAC/M]) as an effective and safe therapeutic regimen to treat people infected with Helicobacter pylori (H. pylori). Researchers undertook this study to investigate effectiveness of standard triple therapy for H. pylori elimination.

Databases like PubMed, Scopus database, Institute for Scientific Information (ISI), EMBASE, and Cochrane Central Register were searched to find out relevant randomized clinical trials that evaluated triple therapy PPIAC/M in the first-line treatment of H. pylori infection and reported elimination rate. Utilizing the random effect model, an analysis of data was done. For assessing heterogeneity, the I2 statistics and Cochrane Q test were performed.

With the aid of STATA, statistical analyses were carried out. In total, 47 randomized clinical trials  [PPIAM: 7 trials and PPIAC: 40 trials] and 4,938 people were included in the final assessment. The per-protocol H. pylori elimination rate was 80% [95% CI: 74-84] and 80% [95% CI: 73-87] for PPIAC and PPIAM regimens, respectively.

The H. pylori elimination rate for PPIAC and PPIAM regimens was 83% [95% CI: 70%-95%] and 83% [95% CI: 75%-90%], and also 77% [95% CI: 68%-88%] and 78% [95% CI: 69%-88%] respectively. On the basis of different treatment durations,  the pooled estimates of per-protocol analysis treatment outcomes were reported to be highest in the 14-day treatment in both regimens.

The PPIAC/M regimens were found to be more effective in the Asian population when compared to European populations. However, adequate data are not available to recommend PPIAC/M as the first-line therapy for H. pylori elimination, concluded the study authors.