Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.
World J Gastroenterol. Nov 21, 2026; 32(43): 122243
Published online Nov 21, 2026. doi: 10.3748/wjg.122243
Published online Nov 21, 2026. doi: 10.3748/wjg.122243
Effects of berberine-containing vs clarithromycin-containing quadruple therapy on intestinal microbiota during Helicobacter pylori eradication
Teng-Wei Cai, Zi-Yan Lv, Wen-Jun Jiang, Ye-Yu Sun, Ling-Xiao Jin, Qian-Qian Li, Xia Chen, Department of Gastroenterology, The First People’s Hospital of Wenling, Affiliated Wenling Hospital, Wenzhou Medical University, Wenling 317500, Zhejiang Province, China
Zhi-Kai Chen, Chen-Mei Xia, Department of Gastroenterology, The First People’s Hospital of Wenling (Taizhou University Affiliated Wenling Hospital), School of Medicine, Taizhou University, Wenling 317500, Zhejiang Province, China
Co-first authors: Teng-Wei Cai and Zhi-Kai Chen.
Author contributions: Cai TW and Chen ZK contributed equally to this work, as they are co-first authors; Cai TW and Chen ZK were involved in the study concept, design, and data collection; Jiang WJ and Chen X were involved in securing funding for the project; Lv ZY, Jiang WJ and Li QQ were involved in the interpretation of data; Sun YY, Jin LX and Xia CM were involved in the collection and analysis of data; Chen ZK, Lv ZY, Jiang WJ, Sun YY, Jin LX, Xia CM and Li QQ were involved in drafting the initial manuscript; Cai TW, Chen ZK, and Chen X were involved with the critical revision of the manuscript for important intellectual content and study supervision; all the authors have reviewed and approved the final manuscript.
AI contribution statement: Portions of this manuscript were edited using AI tools solely for language refinement. The authors carefully reviewed and verified all AI-assisted outputs and take full responsibility for the scientific content of the manuscript.
Supported by Zhejiang Provincial Science and Technology Program of Traditional Chinese Medicine, China, No. 2023ZL784; and Wenling Social Development Science and Technology Project, China, No. 2024S00303.
Institutional review board statement: The study was reviewed and approved by the Institutional Review Board of the First People’s Hospital of Wenling, Affiliated Wenling Hospital, Wenzhou Medical University (No. KY-2024-1008-01).
Clinical trial registration statement: Retrospective trial registration submitted; registration number pending official review.
Informed consent statement: All study participants, or their legal guardians, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CONSORT 2010 statement: The authors have read the CONSORT 2010 Statement, and the manuscript was prepared and revised according to the CONSORT 2010 Statement.
Data sharing statement: Technical appendix, statistical code, and dataset available from the corresponding author at werla@sina.com.
Corresponding author: Xia Chen, MD, Chief Physician, Department of Gastroenterology, The First People’s Hospital of Wenling, Affiliated Wenling Hospital, Wenzhou Medical University, No. 333 Chuan’an South Road, Chengxi Street, Wenling 317500, Zhejiang Province, China. werla@sina.com
Received: April 14, 2026
Revised: June 15, 2026
Accepted: July 13, 2026
Published online: November 21, 2026
Processing time: 166 Days and 7.1 Hours
Revised: June 15, 2026
Accepted: July 13, 2026
Published online: November 21, 2026
Processing time: 166 Days and 7.1 Hours
Core Tip
Core Tip: This study compares berberine and clarithromycin-based therapy for Helicobacter pylori (H. pylori) eradication. The two regimens have comparable H. pylori eradication efficacy (80.95% vs 75.00%). Berberine causes milder intestinal flora disturbance, maintains flora homeostasis, enriches beneficial bacteria, and reduces antibiotic resistance risk, serving as a promising alternative for H. pylori eradication, especially in antibiotic-resistant populations.