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.
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.
Authors: Antonio Rollan; Juan Pablo Arab; M Constanza Camargo; Roberto Candia; Paul Harris; Catterina Ferreccio; Charles S Rabkin; Juan Cristóbal Gana; Pablo Cortés; Rolando Herrero; Luisa Durán; Apolinaria García; Claudio Toledo; Alberto Espino; Nicole Lustig; Alberto Sarfatis; Catalina Figueroa; Javier Torres; Arnoldo Riquelme Journal: World J Gastroenterol Date: 2014-08-21 Impact factor: 5.742
Authors: William R Jacobs; Wendy A Szymczak; Rajagopalan Saranathan; Michael H Levi; Alice R Wattam; Adel Malek; Emmanuel Asare; Daniel S Behin; Debra H Pan Journal: J Clin Microbiol Date: 2020-02-24 Impact factor: 5.948
Authors: Bei Tan; Jyh-Chin Yang; Carol L Young; Shrinivas Bishu; Stephanie Y Owyang; Mohamad El-Zaatari; Min Zhang; Helmut Grasberger; Jia-Ming Qian; John Y Kao Journal: Dig Dis Sci Date: 2017-12-20 Impact factor: 3.199
Authors: Kristina G Hulten; Robert M Genta; Ira N Kalfus; Yi Zhou; Hongjun Zhang; David Y Graham Journal: Gastroenterology Date: 2021-07-19 Impact factor: 33.883