Comparison of multiple treatment regimens in children with Helicobacter pylori infection: A network meta-analysis

Abstract

BackgroundMultiple regimens have been widely used in the eradication treatment of Helicobacter pylori infection in children. However, there is a lack of comparison and evaluation of their effectiveness in different regions of the world.MethodsRandomized controlled trials were retrieved. Review Manager 5.4, Stata SE 15 and R 4.0.4 statistical software were used to analyze date. The ranking probability is assessed according to the surfaces under cumulative ranking (SUCRA).Results163 studies were eligible for this study, involving 336 arms and 18,257 children, and 10 different interventions. The results showed that the eradication rates of sequential therapy with probiotics (SP), bismuth-containing quadruple (Quadruple) therapy, concomitant therapy and PCN therapy were at least 90%. Cumulative ranking showed that SP therapy had the best eradication effect (SUCRA 92.7%) whereas Bismuth-containing triple therapy (B) had the worst (SUCRA 3.5%). Subgroup analysis suggested that SP therapy ranked first in China and other regions, and the ranking of Triple therapy with probiotics therapy (TP) was equally stable (SUCRA 72.0% vs 76.4% respectively). The security of the SP and TP therapy had great advantages.ConclusionsAs for the eradication treatment of Helicobacter pylori infection in children, SP therapy ranks highest. SP and TP therapies are most safe.

Efficacy and safety of probiotic-supplemented bismuth quadruple therapy for the treatment of Helicobacter pylori infection: a systematic review and meta-analysis

“…Indeed, previous publications have not described the most suitable time for probiotic addition. 49 Although the co-administration of probiotics and antibiotic-based therapies can improve the treatment of H. pylori , it should be noted that such regimens have certain drawbacks. One major issue is that the antibiotics may restrain the growth of the probiotics.…”

The Efficacy of Paraprobiotic, Probiotic, and Mineral Supplementation on the Eradication Rate of Helicobacter pylori in Patients with Dyspepsia: A Randomized Clinical Trial

“…Comparatively, triple therapy had a lesser amount of efficacy than most of the treatment regimens (eradication rate 72.8%, 95% CI, 71.4-74.2; SUCRA value 17.2%). Mixture of various probiotics, starting probiotics afore or next triple therapy, and probiotic prescription for extended period can increase therapeutic beneficiary outcome in these patients [30].…”

Helicobacter pylori and the Human Gastrointestinal Microbiota: A Multifaceted Relationship

“…Among these, the cumulative ranking showed that the children who used sequential therapy with probiotics in addition to antibiotics had the best outcome in terms of efficacy, while bismuth-containing regimens achieved the worst result. With this meta-analysis, it was possible to point out the higher safety profile of eradication therapies in combination with probiotics in the pediatric population as well [86].…”