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

• Wenzhen Yuan

  The first hospital of Lanzhou University The Evidence-Based Medicine Center 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

Abstract

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.<br> 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.<br> 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.<br> 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.<br> 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.<br>

Journal

• Internal Medicine

  Internal Medicine 49 (12), 1103-1109, 2010

  The Japanese Society of Internal Medicine

Keywords

• <i>Helicobacter pylori</i>
• first-line treatment
• culture-guided triple therapy
• standard triple therapy
• overall cost
• Meta-Analysis

Details

• CRID: 1390001204870014848
• NII Article ID: 130000251636
• DOI: 10.2169/internalmedicine.49.3031
• ISSN: 13497235
• ISSN: 09182918
• Web Site: http://www.jstage.jst.go.jp/article/internalmedicine/49/12/49_12_1103/_pdf
• Web Site: https://search.jamas.or.jp/link/ui/2011064747
• Text Lang: en
• Data Source:
  • JaLC
  • Crossref
  • CiNii Articles
• Abstract License Flag: Disallowed