MedWire News: For people infected with the stomach ulcer-causing bug Helicobacter pylori, treatment with high-dose stomach acid-suppressing drugs called proton pump inhibitors is more effective than standard-dose treatment, study results show.

Helicobacter pylori is recognised as the main cause of peptic ulcers. Most patients infected with the bacterium receive 1 week of triple eradication therapy with a proton pump inhibitor and two antibiotics.

However, Dr X Calvet, from Universitat Autònoma de Barcelona in Spain, and colleagues explain that it is not known whether triple therapy with high-dose proton pump inhibitors is more effective at eradicating the bacteria than triple therapy with standard doses of these drugs.

To investigate, the team examined data from six published studies, involving a total of 1703 patients, which compared the effectiveness of high- and standard-dose proton pump inhibitors in 1-week triple eradication therapy.

Analysis of the pooled results revealed that, after 7 days, 82% of patients who received high-dose proton pump inhibitors as part of triple therapy were no longer infected with Helicobacter pylori, compared with 74% of those who received standard dose proton pump inhibitors as part of their treatment.

Patients who received high-dose proton pump inhibitors as part of triple therapy were therefore nearly 10% more likely to achieve successful eradication of the bug than those assigned to standard doses of these drugs.

"Our study suggests that intensifying the degree of acid inhibition by using high-dose proton pump inhibitors may increase the cure rates in patients treated with a 7-day triple therapy," Dr Calvet and team write in the journal Alimentary Pharmacology and Therapeutics.

They conclude: "As the safety profile of high-dose proton pump inhibitors is similar to that of standard dosages, if further evidence confirms this trend, there will be little reason not to use potent acid inhibition in eradication treatment."