Moss Steven F, Chey William D, Daniele Patrick, Pelletier Corey, Jacob Rinu, Tremblay Gabriel, Hubscher Elizabeth, Leifke Eckhard, Malfertheiner Peter
Division of Gastroenterology, Alpert Medical School of Brown University, 222 Richmond St, Providence, RI 02903, USA.
Division of Gastroenterology, University of Michigan Health System, Ann Arbor, MI, USA.
Therap Adv Gastroenterol. 2023 Jun 22;16:17562848231167284. doi: 10.1177/17562848231167284. eCollection 2023.
eradication rates achieved with clarithromycin-based triple therapies are declining due to antibiotic resistance, but data regarding temporal changes in efficacy with these eradication therapies are scarce.
To evaluate the efficacy of clarithromycin-based triple eradication regimens over time.
A comprehensive literature review and time-trend analysis.
Bibliographies of recently published systematic literature reviews were searched and supplemented with a targeted literature review conducted using Medline and Embase databases and ProQuest from conception to May 2021. Studies reporting eradication rates of clarithromycin-based triple therapies were included and temporal trends were estimated using a random-effects model.
Eradication rates for triple therapies containing proton pump inhibitors (PPIs), clarithromycin, and amoxicillin showed a significant decline over the past 23 years ( = 0.0315). However, this decline was not significant when eradication rates achieved with vonoprazan-based triple therapy were included ( = 0.3910).
Vonoprazan-based triple therapy partially mitigated the decline in eradication rates seen with PPI-based triple therapy, likely due to more powerful acid suppression of vonoprazan.
由于抗生素耐药性，基于克拉霉素的三联疗法的根除率正在下降，但关于这些根除疗法疗效随时间变化的数据很少。
评估基于克拉霉素的三联根除方案随时间的疗效。
全面的文献综述和时间趋势分析。
检索最近发表的系统文献综述的参考文献，并辅以使用Medline、Embase数据库和ProQuest从创刊到2021年5月进行的针对性文献综述。纳入报告基于克拉霉素的三联疗法根除率的研究，并使用随机效应模型估计时间趋势。
在过去23年中，含质子泵抑制剂（PPI）、克拉霉素和阿莫西林的三联疗法的根除率显著下降（=0.0315）。然而，当纳入基于沃克帕唑的三联疗法的根除率时，这种下降并不显著（=0.3910）。
基于沃克帕唑的三联疗法部分缓解了基于PPI的三联疗法根除率的下降，这可能是由于沃克帕唑更强的抑酸作用。
