Table 1.
Treatment | Days | No. of patients | Methods of evaluating eradication | Eradication rate % (ITT) | Eradication rate % (PP) | Adverse effects % | Ref. | Type of study | |
Low clarithromycin resistance area (< 20%) | PPI (standard dose, bid) + amoxicillin (1 g, bid) + clarithromycin (500 mg, bid) | 7-10 | 1975 | UBT or H or R | Overall77.3-100 | 0-33 | Mégraud et al[26] | Meta-analysis | |
PPI (standard dose, bid) + amoxicillin (1 g, bid) followed by a triple therapy with a PPI (standard dose, bid) + clarithromycin (500 mg, bid) + metronidazole/tinidazole (500 mg, bid) | 5 + 5 | 5666 | UBT or H or R | Overall 84.3 | 0-44 | Gatta et al[35] | Meta-analysis | ||
High clarithromycin resistance area (≥ 20%) | PPI (standard dose, bid) + amoxicillin (1 g, bid) + levofloxacin (250 mg, bid) | 7-10 | 900 | UBT or H or R | Overall72-96 | 0-52 | Berning et al[32] | Meta-analysis | |
PPI (standard dose, bid) + amoxicillin (1 g, bid) followed by a triple therapy with a PPI (standard dose, bid) + levofloxacin (250/500 mg, bid) + tinidazole (500 mg, bid). | 5 + 5 | 250 | UBT | 96/96.8 | 98.3/98.4 | 22.1-23.5 | Romano et al[46] | RCT | |
PPI (standard dose, bid) + amoxicillin (1 g, bid) + clarithromycin (500 mg, bid) + metronidazole (500 mg, bid) | 5 | 135 | UBT | 91.4 | 91.4 | 35.6 | Kim et al[54] | RCT | |
PPI (high dose, bid) + amoxicillin (1 g, bid) + levofloxacin (500 mg, bid) + tinidazole (500 mg, bid) | 5 | 90 | UBT | 92.2 | 96.5 | 27.8 | Federico et al[47] | RCT | |
PPI (standard dose, bid) + metronidazole (500 mg, bid) + bismuth (120 mg, q.i.d.) + tetracycline (500 mg, q.i.d.) | 10 | 218 | UBT | 92 | 94 | 47 | Malfertheiner et al[18] | RCT | |
PPI (high dose, bid) + amoxicillin (1 g, bid) followed by a quadruple therapy with a PPI (high dose, bid) + amoxicillin (1 g, bid) + clarithromycin (500 mg, bid) + metronidazole (500 mg, bid) | 7 + 7 | 171 | UBT | 90 | 92 | 47 | Molina-Infante et al[66] | RCT |
PPI: Proton pump inhibitor; UBT: Urea breath test; H: Histology; R: Rapid urease test; RCT: Randomized controlled trial; PP: Per-protocol; ITT: Intention-to-treat.