Vonoprazan With Amoxicillin or Amoxicillin and Clarithromycin for the Treatment of Infection.

OBJECTIVES

To describe the pharmacology, efficacy, safety, and potential role of vonoprazan with amoxicillin or amoxicillin and clarithromycin for the treatment of infection in adults.

DATA SOURCES

PubMed, Embase, Cochrane Library, and ClinicalTrials.gov were searched using the terms: (vonoprazan OR voquezna) AND ("" OR "") AND amoxicillin with no date limitations up to November 3, 2022.

STUDY SELECTION AND DATA EXTRACTION

Studies assessing the efficacy and safety of vonoprazan with amoxicillin and/or clarithromycin were included and divided into 3 groups based on different comparisons between treatment regimens used in each group.

DATA SYNTHESIS

Ten clinical trials and 17 observational studies were included. Vonoprazan-based therapy demonstrated greater acid inhibition and similar or higher efficacy than proton-pump inhibitor (PPI)-based therapy in treatment-naïve patients and with clarithromycin-resistant infections.

RELEVANCE TO PATIENT CARE AND CLINICAL PRACTICE

Proton-pump inhibitor-based therapies have not reached the desired successful eradication rate of 90% for infection. Vonoprazan-based therapies being at least as effective as PPI-based therapies offer an alternative for patients with infection.

CONCLUSION

Vonoprazan-based therapies were effective and well tolerated for the treatment of infection in adults. These regimens provide an important alternative with prolonged acid inhibition, lower potential for CYP2C19 polymorphism, and at least comparable efficacy and safety versus PPI-based therapies in patients with infections. Thus, vonoprazan-based therapy should be considered for certain patients, for example, those with failure to PPI-based treatments.