Azithromycin-containing versus standard triple therapy for Helicobacter pylori eradication: A meta-analysis

Table 1 Characteristics of included studies comparing Helicobacter pylori (H pylori) eradication efficacy of azithromycin-containing triple therapy versus standard triple therapy

Authors	Country	Form	Trial design	Case No. (Az/con)	Patients	Diagnostic methods	Azithromycin regimen	% Eradication (n)	% Adverse effects (n)	Triple therapy	Days of antibiotics	% Eradication (n)	% Adverse effects (n)	Q
Lu et al[24], 2007	China	JA	Single centre RCT	85 (43/42)	H pylori positive	RUT/	O (20 mg bid)	ITT 84 (36/43)	26 (11/43)	O (20 mg bid)	7	ITT 69 (29/42)	19 (8/42)	3
					Chronic active gastritis	RUT (30 d later)	Lev (200 mg bid)	PP 90 (36/40)		A (1 g bid)		PP 72.5 (29/40)
							Az (500 mg o.d.)			C (500 mg bid)
Kang et al[25], 2006	Korea	JA	Single centre RCT	78 (17/61)	H pylori positive	Histology + RUT or UBT/	O (20 mg bid)	ITT 70.6 (12/17)	11.8 (2/17)	O (20 mg bid)	7	ITT 80.3 (49/61)	41.0 (25/61)	3
					Adults	Histology + RUT	Lev (500 mg o.d.)	PP 70.6 (12/17)		A (1 g bid)		PP 80.3 (49/61)
						or UBT (8 wk later)	Az (500 mg o.d.)			C (500 mg bid)
Iacopini et al[26], 2005	Italy	JA	Single centre RCT	164 (83/81)	H pylori positive	Histology + UBT/	E (20 mg o.d.)	ITT 65 (54/83)	12 (9/77)	E (20 mg bid)	7	ITT 65 (53/81)	30 (22/70)	4
					Peptic ulcer and	UBT + HpSA	Lev (500 mg o.d.)	PP 70 (54/77)		A (1 g bid)		PP 76 (53/70)
					GERD adults	(8 wk later)	Az (500 mg o.d.)			C (500 mg bid)
Zhao et al[27], 2005	China	JA	Single centre RCT	98 (49/49)	H pylori positive	Histology + RUT/	O (20 mg bid)	ITT 73.5 (36/49)	/	O (20 mg bid)	7	ITT 30.6 (15/49)	/	3
					Active duodenal ulcer	RUT + Histology	A (1 g bid)	PP 76.6 (36/47)		A (1 g bid)		PP 31.3 (15/48)
						(4 wk later)	Az (1 g o.d.) 3 d			M (500 mg bid)
Chen et al[28], 2004	China	JA	Single centre RCT	100 (55/45)	H pylori positive	Histology + UBT/	O (40 mg o.d.)	ITT 92.7 (51/55)	5 (3/55)	O (40 mg o.d.)	7	ITT 93.3 (42/45)	17.8 (8/45)	2
					Active duodenal ulcer	UBT (6 wk later)	A (1 g bid)	PP 92.7 (51/55)		A (1 g bid)		PP 93.3 (42/45)
							Az (500 mg o.d.) 3 d			C (500 mg bid)
Chen et al[29], 2002	China	JA	Single centre RCT	47 (24/23)	H pylori positive	Histology + RUT/	L (30 mg o.d.)	ITT 92 (22/24)	4 (1/24)	O (20 mg bid)	7	ITT 91 (21/23)	9 (2/23)	3
					Chronic gastritis adults	UBT (4 wk later)	M (400 mg bid) 3 d	PP 92 (22/24)		M (400 mg bid)		PP 91 (21/23)
							Az (500 mg o.d.) 3 d			C (500 mg bid)
Ivashkin et al[30], 2002	Russia	JA	Multicenter RCT	100 (50/50)	H pylori positive	Histology + RUT/	O (20 mg bid)	ITT 72 (36/50)	/	O (20 mg bid)	7	ITT 30 (15/50)	/	4
					Active duodenal	Histology + RUT (8 wk later)	A (1 g bid)	PP 75 (36/48)		A (1 g bid)		PP 31 (15/49)
					Ulcer adults		Az (1 g o.d.) 3 d			M (500 mg bid)
Laurent et al[31], 2001	France	JA	Multicenter RCT	247 (64/78/70)	H pylori positive	Histology + RUT/	O (20 mg bid)	ITT 37.5 (24/64)	56.9 (33/58)	O (20 mg bid)	7	ITT 71.8/61.4 (56/78) (43/70)	57.7/66.1	4
					Non-ulcer dyspepsia	UBT (4-6 wk later)	A (1 g bid)	PP 41.4 (24/58)		C (500 mg bid)/C (250 mg bid)		PP 78.9/69.4 (56/71) (43/62)	(41/71) (41/62)
							Az (500 mg o.d.) day 1 + (250 mg o.d.) days 2-5			A (1 g bid)/M (500 mg bid)
Vcev et al[32], 2000	Croatia	JA	Single centre RCT	110 (55/55)	H pylori positive	Histology + RUT/	P (40 mg bid)	ITT 71 (39/55)	14 (7/50)	P (40 mg bid)	7	ITT 78 (43/55)	17 (9/53)	3
					Active duodenal ulcer	Histology + RUT	A (1 g bid)	PP 78 (39/50)		A (1 g bid)		PP 81 (43/53)
						(8 wk later)	Az (500 mg o.d.) 6 d			C (500 mg bid)
Laine et al[33], 1999	USA	JA	Single centre RCT	120 (40/40/40)	H pylori positive	Histology or serology + UBT/	O (80 mg o.d.)	ITT 65 (26/40)	3 (1/38)	O (80 mg o.d.)	10	ITT 35/78 (14/40) (31/40)	8/15 (3/37) (5/33)	3
					Symptomatic and	UBT (6 wk later)	M (750 mg o.d.)	PP 66 (25/38)		M (750 mg o.d.)		PP 35/79 (13/37) (26/33)
					Asymptomatic adults		Az (500 mg o.d.) 7 d			A (1.5 g o.d.)/C (1 g o.d.)
Trevisani et al[34], 1998	Italy	JA	Single centre RCT	160 (80/80)	H pylori positive	RUT + Histology/	L (30 mg bid) days 1-4	ITT 73.3 (59/80)	1.3 (1/73)	O (20 mg o.d.)	7	ITT 81.2 (65/80)	2.6 (2/76)	4
					Symptomatic adults	RUT + Histology (4 wk later)	T (2000 mg o.d.) day 3	PP 80.8 (59/73)		C (250 mg bid)		PP 85.5 (65/76)
							Az (500 mg o.d.) days 2-4			T (500 mg bid)
Caselli et al[35], 1997	Italy	JA	Multicenter RCT	120 (60/60)	H pylori positive	Histology + RUT/	L (30 mg o.d.)	ITT 93.3 (56/60)	/	O (20 mg o.d.)	7	ITT 86.7 (52/60)	/	3
					Gastritis with or	Histology (7-8 wk later)	M (250 mg bid) 3 d	PP 93.3 (56/60)		C (250 mg bid)		PP 91.2 (52/57)
					without peptic ulcer		Az (500 mg o.d.) 3 d			T (500 mg bid)
Leri et al[36], 1997	Italy	Ab	Single centre RCT	123 (41/41/41)	H pylori positive	Histology + RUT	O (20 mg bid)	ITT 68 (28/41)	/	O (20 mg bid)	14	ITT 80/97 (33/41) (40/41)	/	2
							M (500 mg bid) 10 d			M (500 mg bid) 10 d
							Az (500 mg o.d.) 6 d			A (1 g bid) /C (500 mg t.d.)
Cammarota et al[37], 1996	Italy	JA	Single centre RCT	70 (35/35)	H pylori positive	Histology + RUT/	L (30 mg o.d.)	ITT 57 (20/35)	18 (6/33)	L (30 mg o.d.)	7	ITT 80 (28/35)	26 (9/34)	3
					Symptomatic adults	Histology + RUT (8 wk later)	A (1 g bid)	PP 61 (20/33)		A (1 g bid)		PP 82 (28/34)
							Az (500 mg o.d.) 3 d			C (250 mg bid)

Ab: Abstract; JA: Journal article; C: Clarithromycin; A: Amoxicillin; Az: Azithromycin; M: Metronidazole; T: Tinidazole; Lev: Levofloxacin; E: Esomeprazole; P: Pantorazole; O: Omeprazole; L: Lanzoprazole; UBT: 13C-urea breath test; RUT: Rapid urease test; HpSA: H pylori stool antigen; Q: quality score; RCT: Randomized controlled trial; ITT: Intent-to-treat analysis; PP: Per-protocol analysis.