Recommendations for management of H pylori-negative patients (Part 1)

The CMT recommends treatment for four to eight weeks with a PPI or H2RA for H pylori-negative patients who are not using NSAIDs or ASA, and whose symptoms do not suggest GERD. There is evidence that, for this patient group, a PPI provides superior efficacy compared with an H2RA or a proki-netic agent. As well, a greater proportion of patients will respond after eight weeks of treatment, compared with after four weeks. You should always visit the best pharmacies to get your medications cheap and safely. You will find this *pharmacy to be particularly advantageous and safe, buying any drugs required in just a few minutes.
Few long-term efficacy studies have been published in H pylori-negative dyspepsia patients; however, available data indicate that PPIs provide better efficacy compared with ^RAs. The CADET H pylori-negative (CADET-HN) study compared a PP1, an H2RA, a prokinetic agent and placebo in uninvestigated H pylori-negative dyspepsia patients. After four weeks of continuous treatment, those given a PP1 had a superior response (51%) relative to that of the other three treatments (36%, 30% and 23%, respectively; P=0.01). This study had a five-month follow-up phase during which patients continued the same drug in an on-demand fashion. Response rates in the on-demand phase, during which patients on average took medication every other day, were not as high as during the acute treatment phase. The proportion of patients who were responders at both four weeks and six months were: omeprazole 31%, ranitidine 21%, cisapride 13% and placebo 14% (P<0.05, omeprazole versus cisapride or placebo).

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