Ten-day sequential therapy for Helicobacter pylori eradication in children: a systematic review of randomized controlled trials

Abstract

To assess the efficacy and safety of 10-day sequential therapy for Helicobacter pylori (H.pylori) eradication in children. The databases of Cochrane Central Register of Controlled Trials (CENTRAL, 2013,N01), Medline, Embase, OVID, Chinese Biological Medicine database (CBMDisc), CNKI, Chinese VIP and WANFANG (all from 2000-2013) were searched. And manual searches were performed for the relevant journals and conference proceedings. Prospective, randomized controlled trials of 10-day sequential therapy for H.pylori eradication in children were selected. The systematic review was conducted with the method recommended by The Cochrane Collaboration. Fifteen trials with a total of 1348 patients were included for analysis. The meta-analysis showed: (1) H.pylori eradication rates: 10-day sequential therapy were superior to triple therapy (80.78% (521/645) vs 69.84% (491/703), OR 2.13, 95%CI: 1.62-2.80, P < 0.01). It was also superior to 7-day and 10-day standard triple therapy (86.03% (271/315) vs 73.77% (225/305), 79.04% (181/229) vs 65.19% (176/270); OR 2.23, 2.11; 95%CI:1.47-3.36, 1.37-3.24;both P < 0.01) . There were non-superior to 14-day standard triple therapy (73.97% (108/146) vs 70.31% (90/128), OR 1.87, 95%CI: 0.46-7.69, P = 0.38). (2) Adverse effect rate: adverse events were similar between sequential and standard triple therapies (P = 0.58). The 10-day sequential therapy may be a new effective and safe option in treatment of H.pylori infections in children.