Table 1.
Characteristics of studies comparing empirical vs. susceptibility-guided treatment for H. pylori infection.
| Author | Year | Country | Population | Design |
Treatment line |
Susceptibility test |
C res (%) |
M res (%) |
L res (%) |
Empirical regimen |
Eradication rate with empiric regimen | Eradication rate with susceptibility-guided regimen |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Toracchio et al. (2000) | 2000 | Italy | Adults | R | 1st | Agar dilution | 13 | 33 | - | PPI-C-M, 10 d | 42/56 (75%) | 48/53 (91%) |
| Romano et al. (2000) | 2000 | Italy | Adults | R | 1st | E-test | 12 | 22 | - | PPI-C-M, 7 d | 31/40 (77%) | 38/40 (95%) |
| Street et al. (2001) | 2001 | Italy | Adults | NR | 1st | E-test | 16 | 56 | - | PPI/Ra-A-C, 8 d | 61/75 (81%) | 62/63 (98%) |
| Avidan et al. (2001) | 2001 | Israel | Adults | R | 2nd | E-test | 100 | 0 | - | PPI-A-C, 10 d | 5/5 (100%) | 5/5 (100%) |
| Miwa et al. (2003) | 2003 | Japan | Adults | R | 2nd | Dry plate | 71 | - | - | PPI-A-M, 10 d | 36/39 (92%) | 31/38 (82%)* |
| Neri et al. (2003) | 2003 | Italy | Adults | R | 1st | E-test | 7 | 12 | - | PPI-A-C, 7 d RBC-C-M, 7 d |
78/116 (67%) | 88/116 (76%) |
| Romano et al. (2003) | 2003 | Italy | Adults | R | 1st | E-test | 12 | 22 | - | PPI-C-M, 7 d | 58/75 (77%) | 71/75 (95%) |
| Lamouliatte et al. (2003) | 2003 | France | Adults | R | 2nd | E-test | 64 | 53 | - | PPI-A-C, 7 d PPI-A-C, 14 d PPI-A-M, 14 d |
83/172 (48%) | 84/113 (74%) |
| Marzio et al. (2006) | 2006 | Italy | Adults | R | 1st | Agar dilution | 22 | 32 | 10 | PPI-A-L, 10 d | 36/39 (92%) | 39/41 (95%) |
| Marzio et al. (2006) | 2006 | Italy | Adults | R | 2nd | Agar dilution | 43 | 70 | 12 | PPI-A-L, 10 d | 26/32 (81%) | 50/51 (98%) |
| Yahav et al. (2006) | 2006 | Israel | Adults | NR | 2nd | E-test | 59 | 47 | - | PPI-A-C, 7 d PPI-A-M, 7 d PPI-B-T-M, 7 d |
31/49 (63%) | 42/49 (86%) |
| Furuta et al. (2007) | 2007 | Japan | Adults | R | 1st | PCR | 30 | - | - | PPI-A-C, 7 d | 105/150 (70%) | 144/150 (96%)* |
| Kawai et al. (2008) | 2018 | Japan | Adults | R | 1st | PCR (stools) | 48 | - | - | PPI-A-C, 7 d | 25/35 (71%) | 33/35 (94%) |
| Wang et al. (2008) | 2008 | China | Adults | R | 1st | Culture | 10 | - | - | PPI-A-C, 7 d PPI-C-M, 7 d |
57/80 (71%) | 36/40 (90%) |
| Zhou et al. (2010) | 2010 | China | Adults | R | 1st | Agar dilution | 15 | - | - | PPI-C-M, 10 d | 107/135 (79%) | 117/125 (94%) |
| Bontems et al. (2011) | 2011 | Brussels, Italy, France | Children | R | 1st and ≥2nd | E-test | 16 | 20 | - | PPI-A, 5 d + PPI-C-M, 5 d | 68/83 (82%) | 59/82 (72%) |
| Molina-Infante et al. (2012) | 2012 | Spain | Adults | NR | 1st | E-test | 20 | 34 | - | PPI-A-C-M, 10 d | 182/209 (87%) | 70/87 (80%) |
| Lee et al. (2013) | 2013 | Korea | Adults | NR | 1st | PCR | 22 | - | - | PPI-A-C, 7 d PPI-C-M, 7 d |
433/616 (70%) | 176/218 (81%) |
| Cosme et al. (2013) | 2013 | Spain | Adults | NR | 1st | E-test | 13 | - | - | PPI-A-C, 10 d | 51/104 (49%) | 113/134 (84%) |
| Park et al. (2014) | 2014 | Korea | Adults | R | 1st | Agar dilution | 25 | 46 | 37 | PPI-A-C, 7 d | 41/57 (72%) | 54/57 (95% |
| Martos et al. (2014) | 2014 | Spain | Adults | R | 1st | E-test | 9 | - | - | PPI+A+C, 10 d | 36/54 (67%) | 52/55 (94%) |
| Zhuo et al. (2015) | 2015 | China | Adults | R | 1st | Agar dilution | 17 | 95 | 28 | PPI-A-C-B, 14 d | 405/500 (81%) | 281/313 (90%) |
| Dong et al. (2015) | 2015 | China | Adults | R | 1st | E-test, PCR | 40 | 53 | 56 | PPI-A-C-B, 14 d | 33/45 (73%) | 41/45 (91%) |
| Zhou et al. (2016) | 2016 | China | Adults | R | 1st | E-test | 49 | 66 | - | PPI-A-C-B, 10 d PPI-A-C-M, 10 d |
545/700 (78%) | 282/318 (89%)* |
| Kwon et al. (2016) | 2016 | Korea | Adults | NR | 2nd | Agar dilution | 85 | 52 | - | PPI-B-T-M, 14 d PPI-A-Mo, 14 d |
130/178 (73%) | 36/41 (88%) |
| Cosme et al. (2016) | 2016 | Spain | Adults | NR | 1st | E-test | 16 | - | - | PPI-A-C-M, 10 d | 103/118 (87%) | 98/104 (94%) |
| Miyaki et al. (2016) | 2016 | Japan | Adults | NR | 1st | Agar dilution | 30 | - | - | PPI-A-C, 7 d | 101/132 (76%) | 119/128 (93%) |
| Ferenc et al. (2017) | 2017 | Poland | Adults | NR | 1st | E-test | 55 | 57 | 6 | PPI-A, 5 d + PPI-C-M, 5 d PPI-A-L, 14 d |
26/30 (87%) | 43/45 (95%) |
| Liou et al. (2018) | 2018 | Taiwan | Adults | R | ≥3rd | PCR | 92 | 69 | 70 | PPI-A, 7 d + PPI-M-L/C/T, 7 d | 12/20 (60%) | 17/21 (81%) |
| Liou et al. (2018) | 2018 | Taiwan | Adults | R | ≥3rd | PCR | 93 | 66 | 60 | PPI-A, 7 d + PPI-M-L/C/T, 7 d | 148/205 (72%) | 160/205 (78%) |
| Gweon et al. (2018) | 2018 | Korea | Adults | NR | 1st | PCR | 37 | - | - | PPI-A-C, 7 d | 230/319 (72%) | 191/208 (92%) |
| Gweon et al. (2018) | 2018 | Korea | Adults | NR | 2nd | PCR | 37 | - | - | PPI-B-T-M, 7 d | 66/75 (88%) | 8/9 (89%) |
| Huang et al. (2018) | 2018 | Taiwan | Adults | NR | 3rd | E-test | 75 | 67 | 95 | PPI-A-T-M, 14 d | 14/27 (52%) | 35/43 (81%) |
| Mascellino et al. (2018) | 2018 | Italy | Adults | NR | ≥2nd | E-test | 50 | 68 | - | PPI-B-T-M, 14 d PPI-A-L, PPI-A-R Other regimens |
8/10 (80%) | 20/30 (67%) |
| Tanabe et al. (2018) | 2018 | Japan | Adults | NR | 1st | Agar dilution | 23 | 4 | - | PPI-A-C, 7 d | 619/780 /79%) | 198/212 (93%) |
| Ong et al. (2019) | 2019 | Korea | Adults | R | 1st | PCR | 26 | - | - | PPI-A-C-M, 14 d | 169/196 (86%) | 164/201 (82%) |
| Chen et al. (2019) | 2019 | China | Adults | R | 1st | Agar dilution | 35 | 83 | 47 | PPI-B-A-M, 14 d | 82/96 (85%) | 262/286 (92%) |
| Cho et al. (2019) | 2019 | Korea | Adults | NR | 1st | PCR | 23 | - | - | PPI-A-M, 7 d | 186/327 (57%) | 115/150 (77%) |
| Choi et al. (2019) | 2019 | Korea | Adults | NR | 1st | PCR | 24 | - | - | PPI-B-T-M, 14 d | 98/104 (94%) | 48/50 (96%) |
| Byambajav et al. (2019) | 2019 | Mongolia | Adults | NR | 1st | Agar dilution | 37 | 74 | - | PPI-A-C, 10 d PPI-A-C-B, 10 d PPI-A, 5 d + PPI-C-M, 5 d |
204/270 (75%) | 41/46 (89%) |
| Delchier et al. (2019) | 2019 | France | Adults | R | 1st | PCR | 23 | - | 13 | PPI-A-C, 7 d | 152/208 (73%) | 177/207 (85%) |
| Zhang et al. (2020) | 2020 | China | Children | NR | 2nd | Culture | 96 | 4 | 7 | PPI-A-M-B | 74/75 (99%) | 46/64 (72%)* |
| Saracino et al. (2020) | 2020 | Italy | Adults | NR | ≥2nd | E-test | 83 | 67 | 47 | PPI-Pylera®, 10 d | 161/186 (87%) | 875/1037 (84%) |
| Pan et al. (2020) | 2020 | China | Adults | R | 1st | Agar dilution | 67 | 86 | 64 | PPI-A-C-B, 14 d | 100/157 (64%) | 238/310 (77%) |
| Ji et al. (2020) | 2020 | China | Adults | R | ≥2nd | Agar dilution | 67 | 98 | 51 | PPI-A-L-B, 14 d PPI-A-F-B, 14 d |
156/210 (74%) | 164/210 (78%) |
| Bonoso Criado et al. (2021) | 2021 | Spain | Adults | R | 1st | Culture | 23 | 25 | 19 | PPI-B-T-M, 10 d | 43/45 (96%) | 39/43 (91%) |
| Bonoso Criado et al. (2021) | 2021 | Spain | Adults | R | 2nd | Culture | 23 | 25 | 19 | PPI-B-T-M, 10 d | 6/6 (100%) | 8/9 (89%) |
| Bonoso Criado et al. (2021) | 2021 | Spain | Adults | R | 3rd | Culture | 23 | 25 | 19 | PPI-B-T-M, 10 d | 2/4 (50%) | 1/1 (100%) |
| Chang et al. (2021) | 2021 | Korea | Adults | NR | 1st | PCR | 32 | - | - | PPI-A-C, 7d | 183/198 (92%) | 256/292 (88%) |
| Choe et al. (2021) | 2021 | Korea | Adults | NR | 1st | PCR | - | - | - | PPI-A-C, 14d | 22/27 (82%) | 124/139 (89%) |
| Choe et al. (2021) | 2021 | Korea | Adults | NR | 1st | PCR | - | - | - | PPI-A, 5 d + PPI-C-M, 5 d | 91/111 (82%) | 8/10 (80%) |
| Choe et al. (2021) | 2021 | Korea | Adults | NR | 1st | PCR | - | - | - | PPI-B-T-M, 14 d | 15/17 (88%) | 55/60 (92%) |
| Choi et al. (2021) | 2021 | Korea | Adults | R | 1st | PCR | 26 | - | - | PPI-A-C-M, 10 d | 88/107 (82%) | 91/110 (83%) |
| Cha et al. (2021) | 2021 | Korea | Adults | R | 1st | PCR | 22 | - | - | PPI-B-T-M, 7 d | 142/161 (88%) | 118/147 (80%) |
R, randomized; NR, non-randomized; C res, resistance to clarithromycin; M res, resistance to metronidazole; L res, resistance to levofloxacin; PPI, proton pump inhibitor; A, amoxicillin; C, clarithromycin; M, metronidazole (or tinidazole); B, bismuth; T, tetracycline; L, levofloxacin; Mo, moxifloxacin; R, rifabutine; Ra, ranitidine; RBC, ranitidine bismuth citrate; Pylera®, single capsule containing bismuth, tetracycline, and metronidazole; -, information was not reported/available. Eradication rate was calculated by intention-to-treat analysis.
*
The dose of PPI in the susceptibility-guided regimen was also based on CYP2C19 gene polymorphism.