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Increasing antimicrobial resistance decreases the success of clarithromycin-containing therapies for Helicobacter pylori eradication. Researchers performed both a standard meta-analysis and a Bayesian network meta-analysis of 117 studies evaluating eradication rates of 17 first-line regimens for H. pylori in 32,852 treatment-naive patients. Subgroup analyses were conducted for countries with high (>15%) and low (<15%) clarithromycin resistance rates.
Longer therapies were more successful than 7-day therapies. Compared with all therapies, 14-day sequential therapy had the highest effectiveness both overall (odds ratio, 3.7) and in areas of high clarithromycin resistance (OR, 6.5). In areas of low clarithromycin resistance, ≥10-day hybrid ther…