RESUMO
Introducción: La prevalencia de la infección por Helicobacter pylori afecta casi al 50% de la población mundial, siendo un factor de riesgo para enfermedades benignas y malignas gastrointestinales. El aumento de la resistencia al tratamiento antibiótico contra esta infección ha presentado un dilema en el abordaje de otras alternativas en la terapéutica. Objetivo: Determinar la eficacia del suplemento de vitaminasC y E añadido al tratamiento antibiótico en la erradicación de la infección por H. pylori. Métodos: Se realizó una revisión sistemática en las bases de datos de MedLine, Embase y Cochrane Central Register of Clinical Trials (CENTRAL), para estudios que evaluaran la eficacia del suplemento de vitaminasC y/o E en el tratamiento antibiótico de infección por H. pylori. El resultado principal fue erradicación de la infección y el secundario fueron efectos adversos. El metaanálisis fue elaborado mediante el método de efectos aleatorios. Resultados: Se incluyeron 10 estudios y se hicieron 2 grupos. El primero comparó el uso de suplemento de vitaminasC y E incluyendo 973 pacientes, en el cual sin discriminar el número de antibióticos no se obtuvo una relación con la erradicación de la infección (OR: 1,98 [IC95%: 0,92-4,29], p=0,08). La terapia triple o cuádruple antibiótica no tuvo un efecto sobre la erradicación (OR: 1,80 [IC95%: 0,64-5,08], p=0,26, y OR: 2,84 [IC95%: 0,51-15,56], p=0,22, respectivamente). En el grupo en que solo se evaluó el uso de vitaminaC se incluyeron 702pacientes, pero no se obtuvo un efecto sobre la erradicación (OR: 1,17 [IC95%: 0,58-2,31], p=0,65). Los efectos adversos solo fueron reportados en 4 estudios, siendo el más frecuente las náuseas. Conclusiones: El suplemento de vitaminasC y E en la terapia antibiótica contra H. pylori no tuvo ningún efecto. Sin embargo, los estudios presentaron bastantes sesgos y diferencias en la posología de los suplementos y antibióticos
Introduction: Helicobacter pylori infections affect almost 50% of the world population, constituting a risk factor for benign and malignant gastrointestinal diseases. The increased resistance to antibiotic treatment against this infection represents a dilemma in the search of other therapeutic alternatives. Objective: To determine the efficacy of the use of vitaminC and E supplements concomitantly to antibiotic treatment against H. pylori infections. Methods: We performed a systematic review on the MedLine (PubMed), Embase and Cochrane Central Register of Clinical Trials (CENTRAL) databases, searching for studies evaluating the efficacy of vitaminC and/or E supplements in the antibiotic treatment of H. pylori infections. The primary outcome was eradication of the infection. The secondary outcome was the adverse effects. The meta-analysis was conducted using the random effects method. Results: Ten studies were included and analyzed in two groups. The first group, which was comprised by 973patients, compared the use of supplementation with vitaminC and E, showing that, without discriminating the number of antibiotics used, there was no relationship with the eradication of the infection (OR: 1.98 [95%CI: 0.92-4.29] P=.08). The triple or quadruple antibiotic therapy had no effect on eradication rates either (OR 1.80 [95%CI: 0.64-5.08] P=.26 and OR: 2.84 [95%CI: 0.51-15.56] P=.22, respectively). No effect on the eradication rates was observed either in the group that only assessed the use of vitaminC, comprised by 702patients (OR: 1.17 [95%CI: 0.58-2.31] P=.65). Only four studies reported adverse effects, the most common one being nausea. Conclusions: Supplementation with vitaminC and E in the antibiotic treatment against H. pylori has no effect. However, the reviewed studies had several biases and differences in the dosage of the supplements and antibiotics administered
Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Ácido Ascórbico/uso terapêutico , Vitamina E/uso terapêutico , Helicobacter pylori/patogenicidade , Infecções por Helicobacter , Vitaminas na Dieta/uso terapêutico , AntibacterianosRESUMO
INTRODUCTION: Helicobacter pylori infections affect almost 50% of the world population, constituting a risk factor for benign and malignant gastrointestinal diseases. The increased resistance to antibiotic treatment against this infection represents a dilemma in the search of other therapeutic alternatives. OBJECTIVE: To determine the efficacy of the use of vitaminC and E supplements concomitantly to antibiotic treatment against H. pylori infections. METHODS: We performed a systematic review on the MedLine (PubMed), Embase and Cochrane Central Register of Clinical Trials (CENTRAL) databases, searching for studies evaluating the efficacy of vitaminC and/or E supplements in the antibiotic treatment of H. pylori infections. The primary outcome was eradication of the infection. The secondary outcome was the adverse effects. The meta-analysis was conducted using the random effects method. RESULTS: Ten studies were included and analyzed in two groups. The first group, which was comprised by 973patients, compared the use of supplementation with vitaminC and E, showing that, without discriminating the number of antibiotics used, there was no relationship with the eradication of the infection (OR: 1.98 [95%CI: 0.92-4.29] P=.08). The triple or quadruple antibiotic therapy had no effect on eradication rates either (OR 1.80 [95%CI: 0.64-5.08] P=.26 and OR: 2.84 [95%CI: 0.51-15.56] P=.22, respectively). No effect on the eradication rates was observed either in the group that only assessed the use of vitaminC, comprised by 702patients (OR: 1.17 [95%CI: 0.58-2.31] P=.65). Only four studies reported adverse effects, the most common one being nausea. CONCLUSIONS: Supplementation with vitaminC and E in the antibiotic treatment against H. pylori has no effect. However, the reviewed studies had several biases and differences in the dosage of the supplements and antibiotics administered.
