Abstract

BACKGROUND: H. pylori infection, one of the most prevalent infectious diseases, can cause a severe health problem. Therefore, it seems to be crucial to effectively counter the H. pylori infection by a well-tolerated eradication regimen. However, since discovering H. pylori, the optimal treatment against its disease is still unclear and remains controversial. OBJECTIVES: The present study aims to estimate the efficacy of standard triple therapy for eradicating H. Pylori by systematic review and meta-analysis. METHODS: We identified randomized clinical trials RCTs, which consist of triple therapy PPIAC/M Omeprazole, Amoxicillin, and Clarithromycin/Metronidazole in the first-line treatment of H. pylori infection and reported eradication rate through electronic and manual searches in PubMed, ISI, EMBASE, the Cochrane Central Register and Scopus databases. Data were analyzed using the random effect model, and we used the Cochrane Q test and I2 statistics to assess heterogeneity. Statistical analyses were performed using STATA version 12. RESULTS: forty-seven RCTs PPIAC: 40 RCTs and PPIAM: 7 RCTs with 4,938 patients selected as eligible for the final analysis. Per-protocol eradication rate was 80% 95% CI: 74-84 and 80% 95% CI: 73-87 for PPIAC and PPIAM regimens, respectively. The eradication rate for PPIAC and PPIAM regimens was 83% 95% CI: 70%-95% and 83% 95% CI: 75%-90% was also 77% 95% CI: 68%-88% and 78% 95% CI: 69%-88% respectively. Based on different treatment durations, the pooled estimates of PP per-protocol analysis treatment outcomes were found the highest in 14-day treatment in both regimens. CONCLUSION: Standard triple therapy PPIAC/M is recommended to be an effective and safe regimen, although adequate data are not available to suggest PPIAC/M as the first-line therapy for H. Pylori infection. Interestingly, our analysis demonstrated that PPIAC/M regi-mens were more effective in Asian than European populations.