Table 1.
Characteristics of included studies.
| Authors (Year, Country) | Study Design | Patient Characteristics | Treatment Regimens and Confirmatory Test for H. pylori Eradication |
|---|---|---|---|
| Zhang et al. (2022, China) [23] | RCT | Age: 18–75 years Penicillin allergy: not well defined Without previous eradication therapy Peptic ulcer: 15.8–19.4% |
PBM1M2: R 10 mg BID + M2 100 mg BID + M1 400 mg TID + B 220 mg BID PBLM2: R 10 mg BID + M2 100 mg BID + L 400 mg QD + B 220 mg BID Duration: 14 days Confirmed: UBT at 4–12 weeks after treatment |
| Tepes et al. (2021, Slovenia) [24] | Analysis of multicenter prospective registry | Age: 18–90 years Penicillin allergy: not well defined Without previous eradication therapy Peptic ulcer: N/A |
PC1M1: E 40 mg BID + C1 500 mg BID + M1 400 mg TID Duration: 14 days Confirmed: UBT at least 4 weeks after treatment. |
| Sue et al. (2021, Japan) [22] | Single-center, open-label, single-arm | Age: ≥20 years Penicillin allergy: diagnosis by a physician Failed first-line therapy Gastroduodenal ulcer: 23.5% |
VM1S: V 20 mg BID + M1 250 mg BID + SF 100 mg BID Duration: 7 days Confirmed: UBT at 4 weeks after treatment |
| Nyssen et al. (2020, European) [25] | Prospective registry of the clinical practice of European gastroenterologists (27 countries) | Age: Mean 53 ± 15 years Allergic to penicillin: not well defined With or without prior H pylori treatment Peptic ulcer: 17% |
PC1M1: PPI + C1 + M PC1L: PPI + C1 + L PBTM1: PPI + B + T + M PM1L: PPI + M + L PC1LM1: PPI + C1 + L+ M Duration: N/A Confirmed: Locally accepted/validated diagnostic methods at least 4 weeks after treatment |
| Gao et al. (2019, China) [26] | Retrospective | Age: 19–75 years Penicillin allergy: not well defined Without previous eradication therapy Peptic ulcer: 17.5% |
PBTM1: LPZ 30 mg BID + B 150 mg TID + T 500 mg TID + M1 400 mg TID Duration: 14 days Confirmed: UBT at 4 weeks after treatment |
| Song et al. (2019, China) [27] | Prospective single center | Age: 42.8 ± 13.7 years Penicillin allergy: well defined Without previous eradication therapy Peptic ulcer: 9.2% |
Cefuroxime 500 mg BID + L 500 mg QD + E 20 mg BID + B 220 mg BID Duration: 14 days Confirmed: UBT at 8–12 weeks after treatment |
| Long et al. (2018, China) [28] | Prospective, randomized, open-label, single-center | Age: 25–65 years Penicillin allergy: not well defined Without previous eradication therapy Peptic ulcer: 15.2% |
PC1M1: E 20 mg BID + C1 500 mg BID + M1 400 mg QID BEC1M1: E 20 mg BID + C1 500 mg BID + M1 400 mg QID + B 600 mg BID Duration: 14 days Confirmed: UBT at 6 weeks after treatment |
| Osumi et al. (2017, Japan) [29] | Retrospective | Age: 26–83 years Penicillin allergy: not well defined Unknown prior treatments Peptic ulcer: N/A |
20 mg R + 250 mg M1 + 100 mg M2 BID Duration: 7 days Confirmed: UBT at least 12 weeks after treatment |
| Sue et al. (2017, Japan) [30] | Prospective study for vonoprazan, Retrospective for PPI | Age: ≥20 years Penicillin allergy: not well defined Without previous eradication therapy Peptic ulcer: 28% |
VC1M1: V 20 mg + C1 200 or 400 mg + M1 250 mg BID PC1M1: PPI (30 mg BID LPZ or 20 mg BID E) + C1 200 or 400 mg BID + M1 750 mg BID Duration: 7 days Confirmed: UBT at least 4 weeks after treatment |
| Mori et al. (2017, Japan) [31] | Prospective, single arm, nonrandomized | Age: ≥20 years Penicillin allergy: not well defined With or without prior treatment Peptic ulcer: 15.8% |
PM1S: 20 mg E BID + 250 mg M1 BID + 100 mg SF BID Duration: 10 days Confirmed: UBT or HpSA at 12 weeks after treatment |
| Ono et al. (2017, Japan) [32] | Retrospective | Age: mean 59 years Penicillin allergy: not well defined With or without prior treatment Peptic ulcer: 17.8% |
PC1M1: C1 200 mg BID + M1 250 mg BID + LPZ 30 mg BID or R 20 mg BID VC1M1: C1 200 mg BID + M1 250 mg BID + V 20 mg BID PM1S: M1 250 mg BID + SF 100 mg BID + LPZ 30 mg BID or R 20 mg BID VSM1: M1 250 mg BID + SF 100 mg BID + V 20 mg BID Duration: 7 days Confirmed: UBT more than 8 weeks after treatment |
| Segarra-Newnham et al. (2004, USA) [33] | Retrospective | Age: 29–84 years Penicillin allergy: not well defined Unknown prior treatments Peptic ulcer: N/A |
PC1M1: M1 500 mg BID + C1 500 mg BID + PPI BID Duration: 7 days Confirmed: No information |
| Parch et al. (1998, USA) [34] | Single-center, open, randomized, parallel | Age: 18–75 years Penicillin allergy: not well defined Unknown prior treatments Peptic ulcer: 100% |
O 20 mg BID + C1 500 mg TID Duration: 7 days Confirmed: UBT at 4 weeks after treatment |
| Gisbert et al. (2010, Spain) [35] | Prospective multicenter | Age: mean 51 ± 18 years Penicillin allergy: not well defined Without prior treatment, start PC1M1 first, if failed, start PC1L Peptic ulcer: 98% |
PC1M1: O 20 mg BID + C1 500 mg BID + M1 500 mg BID for 7 days PC1L: O 20 mg BID + C1 500 mg + L 500 mg BID for 10 days. Duration: 7 days vs. 10 days Confirmed: UBT at 8 weeks after treatment |
| Tay et al. (2012, Australia) [36] | Retrospective | Age: mean 16–85 years Penicillin allergy: not well defined Failed prior treatment Peptic ulcer: N/A |
R 20 mg TID + B 240 mg QID + RFB 150 mg BID + C2 500 mg BID Duration: 10 days Confirmed: UBT at least 4 weeks after treatment |
| Liang et al. (2013, China) [37] | Prospective, open label | Age: 18–79 years Penicillin allergy: not well defined Failed one or more prior treatments Peptic ulcer: N/A |
N = 109, results reported for whole group including non-allergic PBTF: LPZ 30 mg BID + B 220 mg BID + T 500 mg TID + FZD 100 mg TID PBTM1: LPZ 30 mg BID + B 220 mg BID + T 500 mg QID + M1 400 mg QID Duration: 14 days Confirmed: UBT at 6 weeks after treatment |
| Matsushima et al. (2006, Japan) [38] | Retrospective | Age: ≥18 years Penicillin allergy: not well defined Without prior treatment Peptic ulcer: N/A |
PTM1: PPI (LPZ 30 mg, O 20 mg, or R 10 mg, QD) + T 500 mg BID + M1 250 mg BID Duration: 7–14 days Confirmed: UBT or by HP stool antigen at more than 2 months after therapy |
| Gisbert et al. (2005, Spain) [39] | Prospective single center | Age: ≥18 years Penicillin allergy: not well defined With or without prior treatment Peptic ulcer: N/A |
PC1M1: O 20 mg BID + C1 500 mg BID + M1 500 mg BID for 7 days BTM1: ranitidine bismuth citrate 400 mg BID + T 500 mg QID + M1 250 mg QID for 7 days PCR: RFB 150 mg BID + C1 500 mg BID + 3rd line O 20 mg BID for 10 days PC1L: L 500 mg BID + C1 500 mg BID + O 20 mg BID for 10 days Duration: 7 days or 10 days Confirmed: UBT at 8 weeks after treatment |
| Rodriguez-torres et al. (2005, Puerto Rico) [40] | Prospective | Age: ≥21 years Penicillin allergy: not well defined With or without prior treatment Peptic ulcer: 0% |
PM1T: E 40 mg + T 500 mg + M1 500 mg QID Duration: 14 days Confirmed: UBT at 4 weeks after treatment |
| Gisbert et al. (2015, Spain) [41] | Prospective multicenter | Age: ≥21 years Penicillin allergy: not well defined With or without prior treatment Peptic ulcer: 9% |
PC1M1: O 20 mg + C1 500 mg + M1 500 mg BID for 7 days. PBTM1: O 20 mg BID + B 120 mg QID + Oxytetracycline 500 mg QID or doxycycline 100 mg BID + M1 500 mg TID for 10 days PC1L: O 20 mg + C1 500 mg + L 500 mg BID for 10 days PC1R: O 20 mg BID + C1 500 mg BID + RFB 150 mg BID for 10 days Duration: 7–10 days Confirmed: UBT at 8 weeks after treatment |
| Adachi et al. (2023, Japan) [20] | Retrospective | Age: > 18 years Penicillin allergy: self-reported With or without prior treatment Peptic ulcer: 3.8% |
PC1M1: C1 200 mg BID + M1 250 mg BID + L 30 mg BID or R 20 mg BID or E 20 mg BID VC1M1: C1 200 mg BID + M1 250 mg BID + V 20 mg BID VM1S: M1 250 mg BID + STFX 50 mg BID + V 20 mg BID Duration: 7 days Confirmed: UBT 6 to 8 weeks after treatment |
| Gao et al. (2023, China) [21] | Cross-sectional retrospective | Age: 18–69 years Penicillin allergy: well defined Without prior treatment Peptic ulcer: 33.8% |
V 20 mg BID + T 500 mg TID (body weight < 70 kg) or QID (body weigh ≥ 70 kg) Duration: 14 days Confirmed: UBT at least 6 weeks after therapy |
Abbreviation: RCT, randomized controlled trial; UBT, urea breath test; BID, twice daily; TID, three times daily; QID, four times daily; QD, one times daily; PP, per protocol analysis; ITT, intention to treat analysis; B, Bismuth compound; C1, Clarithromycin; C2, Ciprofloxacin; E, Esomeprazole FZD, Furazolidone; L, Levofloxacin; M1, Metronidazole; M2, minocycline O, Omeprazole; PPI, proton pump inhibitor; R, Rabeprazole; RBC, ranitidine bismuth subcitrate; RFB, Rifabutin; SF, Sitafloxacin; T, Tetracycline; V, Vonoprazan; LPZ, lansoprazole; HpSA, Helicobacter pylori stool antigen; PM1L, PPI-Metronidazole-Levofloxacin; PC1L, PPI-Clarithromycin-Levofloxacin; PC1M1, PPI-Clarithromycin-Metronidazole; PM1T, PPI-Metronidazole-Tetracycline; PC1R, PPI-Clarithromycin-Rifabutin; PC1M1L, PPI-Clarithromycin-Metronidazole-Levofloxacin; PBTM1, PPI-Bismuth-Tetracycline-Metronidazole; N/A, not available; PBCM1, PPI-Bismuth-Clarithromycin-Metronidazole; PBRC2, PPI-Bismuth-Rifabutin-Ciprofloxacin; PBTF, PPI-Bismuth-Tetracycline-Furazolidone; PBM1M2, PPI-Bismuth-Metronidazole-Minocycline; PBLM2, PPI-Bismuth-Levofloxacin-Minocycline; VSM1, Vonoprazan-Sitafloxacin-Metronidazole; VC1M1, Vonoprazan-Clarithromycin-Metronidazole; PM1S, PPI-Metronidazole-Sitafloxacin.