SynthesisGastroenterology2018
Prevalence of Antibiotic Resistance in Helicobacter pylori: A Systematic Review and Meta-analysis in World Health Organization Regions.
Synthesis in Gastroenterology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 4 registered trials, which are not on this map. Cited by 615 papers, 13 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Helicobacter Pylori Eradication Therapy in Portugal: Prospective, Randomized, Blind and Multicentre Trial on the Efficacy of Quadruple Therapies and Their Clinical Impact, and Immunological and Gut Microbiota Changes
Epidemiology of Helicobacter Pylori Infection in Moscow
Triple Versus Quadruple Therapy with Amoxicillin and Tetracycline for the Eradication of Helicobacter Pylori: a Multicenter Randomized Controlled Trial
Efficacy and Safety of a Triple Eradication Scheme for Helicobacter Pylori Based on Amoxicillin 1g + Clarithromycin 500 mg and Tegoprazan 50 mg vs Amoxicillin 1g + Clarithromycin 500 mg and Esomeprazole 40 mg Twice a Day for 14 Days
Who cites it
615 citing papers in PubMed, 13 syntheses or guidelines pooled it.
- Efficacy of Potassium-Competitive Acid Blockers Versus Proton Pump Inhibitors in Eradication Regimens for Clarithromycin-ResistantPathogens (Basel, Switzerland) · 2026Pooled it
- Asian Pacific Association of Gastroenterology task force recommendations on surveillance forGut · 2026Guideline
- Comparing potassium-competitive acid blocker-based therapies forFrontiers in physiology · 2026Pooled it
- Efficacy and safety of antibiotic regimens forFrontiers in medicine · 2026Pooled it
- Effects of New Media-Based Education on the Treatment of Helicobacter pylori Infection: Systematic Review and Meta-Analysis.Journal of medical Internet research · 2025Pooled it
- Effect of Saccharomyces boulardii supplementation to bismuth quadruple therapy on Helicobacter pylori eradication.BMC gastroenterology · 2025Pooled it
- Clarithromycin-resistant Helicobacter pylori in Africa: a systematic review and meta-analysis.Antimicrobial resistance and infection control · 2025Pooled it
- Bibliometric analysis ofFrontiers in microbiology · 2025Pooled it
- Antibiotic resistance rates inFrontiers in microbiology · 2025Pooled it
- Research trends of nanomaterials inFrontiers in pharmacology · 2025Pooled it
- Pooled it
- Antibiotic resistance in Helicobacter pylori among children and adolescents in East Asia: A systematic review and meta-analysis.Chinese medical journal · 2024Pooled it
- The effects of probiotics supplementation on Helicobacter pylori standard treatment: an umbrella review of systematic reviews with meta-analyses.Scientific reports · 2024Pooled it
- Effect of endoscopic screening for non-cardia gastric cancer: a 12-year report of a population-based randomized trial.BMC medicine · 2026Trial
- Vonoprazan-based dual therapy with amoxicillin or doxycycline versus bismuth-containing quadruple therapy forFrontiers in cellular and infection microbiology · 2026Trial
- Impact of supplementing Limosilactobacillus fermentum MN-LF23 on the eradication of Helicobacter pylori with 14-day standard quadruple therapy: a randomized, double-blind, placebo-controlled trial.Nutrition journal · 2025Trial
- Vonoprazan-based therapy versus standard regimen for Helicobacter pylori infection management in Egypt: an open-label randomized controlled trial.Scientific reports · 2025Trial
- Amoxicillin high-dose dual therapy forWorld journal of gastroenterology · 2025Trial
- Gastric cancer prevention by community eradication of Helicobacter pylori: a cluster-randomized controlled trial.Nature medicine · 2024Trial
- Development and application of an artificial intelligence-assisted endoscopy system for diagnosis of Helicobacter pylori infection: a multicenter randomized controlled study.BMC gastroenterology · 2024Trial
555 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
5 authors.
Funding
Abstract
BACKGROUND &
aimsIn 2017, the World Health Organization (WHO) designated clarithromycin-resistant Helicobacter pylori a high priority for antibiotic research and development. However, there are no clear data on the global distribution of resistance or its clinical effects. We performed a systematic review and meta-analysis to assess the distribution of H pylori resistance to commonly used antibiotics and to measure the association between antibiotic resistance and treatment failure.
methodsWe searched publication databases for studies that assessed rates of H pylori resistance to clarithromycin, metronidazole, levofloxacin, amoxicillin, or tetracycline. Pooled estimates of primary and secondary resistance and 95% confidence intervals (CIs) were grouped by WHO region. The association between antibiotic resistance and treatment failure was measured by extracting data on treatment efficacy in patients with resistant and susceptible isolates and pooling odds ratios with 95% CIs.
resultsWe identified 178 studies, comprising 66,142 isolates from 65 countries. Primary and secondary resistance rates to clarithromycin, metronidazole, and levofloxacin were ≥15% in all WHO regions, except primary clarithromycin resistance in the Americas (10%; 95% CI, 4%-16%) and South-East Asia region (10%; 95% CI, 5%-16%) and primary levofloxacin resistance in the European region (11%; 95% CI, 9%-13%). There was considerable heterogeneity (I
conclusionsResistance of H pylori to antibiotics has reached alarming levels worldwide, which has a great effect on efficacy of treatment. Local surveillance networks are required to select appropriate eradication regimens for each region.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.