Table 4.
Randomized Controlled Trial Comparing the Efficacy of Empirical Therapy versus Tailored Therapy
| Author (year) | Country | Empirical therapy | Tailored therapy | ||||||
|---|---|---|---|---|---|---|---|---|---|
| No. | Regimen | Eradication rate, % (95% CI)* | No. | Method | Target antimicrobials | Eradication rate, % (95% CI)* | |||
| First-line | |||||||||
| Furuta et al. (2007)95 | Japan | 150 | PPI/AMO/CLA, 7 days | 70.0 (69.5–76.7) | 150 | SISAR | CLA | 96.0 (91.3–98.3) | |
| Kawai et al. (2008)73 | Japan | 35 | PPI/AMO/CLA, 7 days | 71.4 (54.7–83.7) | 35 | Nested PCR (stool) | CLA | 94.3 (80.2–99.3) | |
| Lee et al. (2013)94 | Korea | 308 | PPI/AMO/CLA, 7 days | 75.9 (70.5–80.5) | 616 | DPO-PCR | CLA | 91.2 (86.2–94.5) | |
| 308 | PPI/AMO/MET, 7 days | 79.1 (73.9–83.4) | |||||||
| Ong et al. (2019)104 | Korea | 196 | PPI/AMO/CLA/MET, 14 days | 86.2 (80.6–90.4) | 201 | DPO-PCR | CLA | 81.6 (75.6–86.3) | |
| Delchier et al. (2019)96 | France | 208 | PPI/AMO/CLA, 7 days | 73.1 (66.6–78.6) | 207 | PCR/reverse hybridization | CLA/LEV | 85.5 (80.0–89.7) | |
| Choi et al. (2021)105 | Korea | 107 | PPI/AMO/CLA/MET, 10 days | 82.2 (73.8–88.4) | 110 | DPO-PCR | CLA | 82.7 (74.5–88.7) | |
| Cha et al. (2021)106 | Korea | 161 | PPI/BIS/TET/MET, 7 days | 88.2 (82.2–92.4) | 147 | DPO-PCR | CLA | 80.3 (73.0–85.9) | |
| Kim et al. (2022)107 | Korea | 145 | PPI/AMO/CLA/MET, 14 days | 82.8 (75.7–88.1) | 145 | DPO-PCR | CLA | 85.8 (78.8–90.4) | |
| Cho et al. (2022)108 | Korea | 141 | PPI/BIS/AMO/CLA, 14 days | 85.8 (79.0–90.7) | 141 | DPO-PCR | CLA | 80.9 (73.5–86.5) | |
| Hsieh et al. (2022)97 | Taiwan | 91 | PPI/AMO/CLA, 7 days | 75.8 (66.0–83.5) | 91 | PCR-RLFP (gastric juice) | CLA | 89.0 (80.8–94.1) | |
| Toracchio et al. (2000)101 | Italy | 56 | PPI/CLA/TIN, 10 days | 75.0 (62.1–84.5) | 53 | Agar dilution | CLA/TIN | 90.6 (79.2–96.2) | |
| Romano et al. (2000)102 | Italy | 40 | PPI/CLA/MET, 7 days | 77.5 (64.6–90.4) | 40 | E-test | CLA/AMO/MET/TET | 95.0 (88.2–100) | |
| Neri et al. (2003)98 | Italy | 116 | PPI/AMO/CLA, 7 days | 67.2 (58.2–75.1) | 116 | E-test | CLA/AMO/TIN | 75.9 (67.3–82.7) | |
| Romano et al. (2003)103 | Italy | 75 | PPI/CLA/MET, 7 days | 77.3 (66.9–85.7) | 75 | E-test | CLA/AMO/MET/TET | 94.6 (87.6–98.3) | |
| Marzio et al. (2006)109 | Italy | 39 | PPI/AMO/LEV, 10 days | 92.3 (78.8–98.0) | 41 | Agar dilution | CLA/AMO/LEV/RIF | 95.1 (82.8–99.4) | |
| Park et al. (2014)99 | Korea | 57 | PPI/AMO/CLA, 7 days | 71.9 (59.0–81.9) | 57 | Agar dilution | CLA | 94.7 (84.9–98.7) | |
| Martos et al. (2014)100 | Spain | 54 | PPI/AMO/CLA, 10 days | 66.7 (53.3–77.7) | 55 | E-test | CLA | 94.5 (84.4–98.6) | |
| Zhou et al. (2016)110 | China | 350 | PPI/BIS/AMO/CLA, 10 days | 77.4 (73.1–82.0) | 318 | E-test | CLA | 88.7 (85.2–92.1) | |
| 350 | PPI/AMO/CLA/MET, 10 days | 87.0 (83.0–90.7) | |||||||
| Chen et al. (2019)111 | China | 96 | PPI/BIS/AMO/MET, 14 days | 85.4 (78.4–92.5) | 286 | Agar dilution | CLA/MET/LEV | 91.6 (88.4–94.8) | |
| Pan et al. (2020)112 | China | 157 | PPI/BIS/AMO/CLA, 14 days | 63.7 (55.9–70.8) | 310 | Agar dilution | CLA/MET/LEV/AMO/FR | 76.8 (71.7–81.1) | |
| Li et al. (2022)113 | China | 67 | PPI/AMO/FR, 10 days | 85.1 (74.5–91.9) | 134 | E-test | CLA | 80.6 (73.0–86.5) | |
| Second-line | |||||||||
| Miwa et al. (2003)118 | Japan | 39 | PPI/AMO/MET, 10 days | 92.4 (79.0–98.0) | 38 | Dry plate | CLA/MET | 81.6 (66.0–92.0) | |
| Lamouliatte et al. (2003)119 | France | 57 | PPI/AMO/CLA, 7 days | 47.4 (34.4–60.3) | 113 | E-test | CLA/AMO/MET | 74.3 (65.0–82.4) | |
| 58 | PPI/AMO/CLA, 14 days | 34.5 (22.2–46.7) | |||||||
| 57 | PPI/AMO/MET, 14 days | 63.2 (50.6–75.7) | |||||||
| Marzio et al. (2006)109 | Italy | 32 | PPI/AMO/LEV, 10 days | 81.2 (63.5–92.7) | 51 | Agar dilution | CLA/AMO/TIN/RIF/LEV | 98.0 (89.5–99.9) | |
CI, confidence interval; PPI, proton pump inhibitor; AMO, amoxicillin; CLA, clarithromycin; SISAR, serial invasive signal amplification reaction; PCR, polymerase chain reaction; MET, metronidazole; DPO-PCR, dual-priming oligonucleotide-based PCR; LEV, levofloxacin; TET, tetracycline; BIS, bismuth; PCR-RFLP, PCR-restriction fragment length polymorphism; TIN, tinidazole; RIF, rifabutin; FR, furazolidone.
*Eradication rate in intension-to-treat analysis.