Abstract

Background: H. pylori infection, one of the most prevalent infectious diseases, can cause severe health problems. Therefore, it seems to be crucial to effectively counter the H. pylori infection with a well-tolerated eradication regimen. However, since the discovery of H. pylori, the optimal treatment for this 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 involving 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, EM-BASE, the Cochrane Central Register, and Scopus databases. Data were analyzed using the random effect model, and the Cochrane Q test and I2 statistics were used 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 el-igible 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% and 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 in-fection. Interestingly, our analysis demonstrated that PPIAC/M regimens were more effective in Asian than European populations. © 2023 Bentham Science Publishers.