Is Antimicrobial Susceptibility Testing Necessary Before First-line Treatment for Helicobacter pylori Infection? -Meta-analysis of Randomized Controlled Trials-

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概要

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• Background With the wide use of antibiotics, antibiotic-resistant Helicobacter pylori strains are becoming increasingly prevalent. It has been hypothesized that culture-guided therapy might help to increase treatment success. But the effects and the costs still remain controversial. Aims To systematically review the efficacy and the cost of culture-guided triple therapy, compared to standard triple regimen for first-line treatment of Helicobacter pylori infection. Methods A search of the Cochrane Library, PubMed, EMBASE, Science Citation Index Expanded and CBM was performed. Randomized controlled trials comparing culture-guided triple therapy to standard triple therapy in the first-line treatment of Helicobacter pylori infection were selected for meta-analysis. Relative risk was used as a measure of the effect of two regimens mentioned above with a fixed-effects model using the methods of DerSimonian and Laird. Results Five randomized controlled trials totaling 701 patients were included. The meta-analysis showed that culture-guided triple therapy was superior referring to a higher eradication rate from intention-to-treat analyses (RR, 0.84; 95% CI,0.77, 0.90; p<0.00001) and a lower overall cost. Conclusion Culture-guided triple therapy was more effective than standard triple therapy for first-line treatment of Helicobacter pylori infection. Based on the only paper focused on the overall cost, the culture-guided triple therapy was also more cost saving. Antimicrobial susceptibility testing is necessary before first-line treatment for Helicobacter pylori infection.

著者

• Wenzhen Yuan

  The first hospital of Lanzhou University

• Yumin Li

  The second hospital of Lanzhou University, Key laboratory of digestive system tumors, Gansu province

• Quanlin Guan

  The first hospital of Lanzhou University

• Kehu Yang

  The Evidence-Based Medicine Center of Lanzhou University

• Lei Jiang

  The first hospital of Lanzhou University

• Donghai Wang

  Montefiore Medical Center, Albert Einstein College of Medicine

• Lijuan Yang

  The school of Economics of Lanzhou University

関連論文

• Is Antimicrobial Susceptibility Testing Necessary Before First-line Treatment for Helicobacter pylori Infection? -Meta-analysis of Randomized Controlled Trials-
• Moxifloxacin-Based Triple Therapy Versus Clarithromycin-Based Triple Therapy for First-Line Treatment of Helicobacter pylori Infection: A Meta-Analysis of Randomized Controlled Trials
• Is Culture Necessary before First-Line Treatment for Helicobacter pylori Infection?

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