| Background: Helicobacter pylori(H.pylori)eradication rate of empirical standard therapy(EST)goes down yearly.The rise of antibiotic resistance is the key reason of eradication rate decreased,and antibiotic resistance of different countries and regions is different.Some studies concerning the susceptibility-guided antibiotic therapy(SGT)for H.pylori elimination have been reported in the domestic.Comparing the efficacy of susceptibility-guided antibiotic therapy and empirical standard therapy for Helicobacter pylori eradication by using evidence-based medicine and it may provide reference in clinical diagnosis and treatment.Objective: Our aim was to evaluate the curative effect of SGT and EST for H.pylori eradication in the domestic.Methods: Choosing the appropriate search terms and databases,and randomized controlled trials(RCTs)of comparison the treatment outcome of SGT and EST for H.pylori elimination were included.Data including the clinical features of patients,treatment,eradication rate of H.pylori and the occurrence of adverse events were extracted and the quality of the RCTs was assessed.Heterogeneity test were assessed to the studies.Appropriating effect model to merge data and Meta analyses were determined according to the result of heterogeneity test.At the same time,subgroup analysis,safety evaluation,sensitivity analyses and publication bias were considered.Results: Eight literatures were included.Meta-analysis showed that the odds ratio(OR)was 3.53 with the 95% confidence interval(CI)2.33~5.34,the eradication rate of SGT group was higher than EST group and there was obvious difference in the eradication rate between two groups(Z=5.95,P<0.00001)in Intention-To-Treat(ITT)analysis.The OR was 5.22 with the 95% CI 2.88~9.47.The eradication rate of SGT group was higher than EST group and there was obvious difference in the eradication rate between two groups(Z=5.45,P<0.00001)in Per-Protocol(PP)analysis.Susceptibility-guided antibiotic therapy appeared superior in subgroup analyses which compared with empirical triple and quadruple therapy.The side effects ratios between SGT group and EST group had no difference.No significant publication bias is in the included literatures.Conclusions: Compared with EST,H.pylori eradication rate of SGT was higher in domestic population.H.pylori eradication rate of empirical therapy has declined because of high antibiotic resistance.Susceptibility-guided antibiotic therapy provides a new therapeutic method for H.pylori infection and it is worth to promote. |
