Impaired acid secretion may affect drug absorption and may be consequent to corporal H pylori-gastritis, which may affect the absorption of orally administered drugs.
Professor Annibale and colleagues from Italy focused on the evidence of impaired drug absorption associated with H pylori infection.
The researchers systematically searched MEDLINE/EMBASE/SCOPUS databases up to 2008 for English articles.
The research team used keywords including drug malabsorption/absorption, stomach, H pylori, gastritis, gastric acid, gastric pH, hypochlorhydria, gastric hypoacidity.
Study selection was made from 2099 retrieved articles, of which 5 studies were identified as relevant.
|In H pylori-subjects, delavirdine absorption increased by 150% after eradication|
|Alimentary Pharmacology & Therapeutics|
The researchers extracted data on investigated drugs, study type, main features of subjects, study design, intervention type and results.
In all, 5 studies investigated impaired absorption of l-dopa, thyroxine and delavirdine in H pylori infection.
The researchers observed that eradication treatment led to a 21% to 54% increase in l-dopa in Parkinon's disease.
Thyroxine requirement was higher in hypochlorhydric goitre with H pylori-gastritis and thyrotropin levels decreased by 94% after treatment.
In H pylori- and HIV-positive hypochlorhydric subjects, delavirdine absorption increased by 57% with orange juice administration, and by 150% after eradication.
Dr Annibale’s team commented, “A plausible mechanism of impaired drug absorption is decreased acid secretion in H pylori-gastritis patients.”
“H pylori infection and hypochlorhydria should be considered in prescribing drugs the absorption of which is potentially affected by intragastric pH.”