Effectiveness of Classic Triple Therapy Compared with Alternative Regimens for Eradicating H. pylori: A Systematic Review
Bibliographic record
Abstract
Background: Helicobacter pylori infection is associated with peptic ulcer disease, chronic gastritis, and gastric cancer. Classic triple therapy (CTT) has been widely used, but increasing antibiotic resistance has reduced its effectiveness. Objectives: To evaluate the effectiveness of CTT compared with alternative regimens and to summarize adverse events and adherence. Methods: We searched PubMed, Scopus, Web of Science, and Cochrane Library from January 2000 to March 2025. Randomized trials and observational studies assessing eradication rates were included. Two reviewers independently screened the studies, extracted data, and assessed bias using Cochrane RoB or the Newcastle–Ottawa Scale. Outcomes included eradication rate, adverse events, and adherence. Results: Thirteen studies (n = 3490) were included. CTT eradication rates ranged from 61.9% to 88.8%. Sequential, bismuth-based quadruple and high-dose PPI regimens achieved higher rates (>90% in several trials). Adverse events were mild–moderate and most frequent in quadruple therapy, though adherence remained >90%. Evidence certainty varied (moderate to low in most comparisons). Geographic variation in resistance limited generalizability. Conclusions: CTT is less effective in high-resistance regions. Quadruple, sequential, and high-dose PPI regimens provide superior outcomes. Region-specific treatment guided by susceptibility testing is recommended. Registration: Not registered.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.005 | 0.021 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.011 | 0.008 |
| Bibliometrics | 0.006 | 0.006 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.006 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".