Meta-analysis of 19,941 participants shows 83.0% eradication rates for Helicobacter pylori antibiotic regimens.

A systematic review and meta-analysis pooled data from 57 studies encompassing 19,941 participants to assess the efficacy of various antibiotic regimens for Helicobacter pylori infection. The analysis did not report specific setting details or a direct comparator group for the pooled estimate.

The primary outcome measured was eradication rates, which yielded a pooled result of 83.0% (95% CI: 81.4%–84.5%). Heterogeneity across studies was substantial, with an I² value of 87.3%. Adverse events were reported in the included studies, though specific rates, serious adverse events, discontinuations, and overall tolerability were not reported in the aggregate data.

Limitations of this evidence include significant heterogeneity and statistical evidence of publication bias, as indicated by Egger's and Begg's tests. The study phase was not reported, and funding or conflicts of interest were not disclosed. Rising antibiotic resistance is noted as a factor that may cause variable outcomes, suggesting that a single pooled rate may not reflect performance in all clinical contexts.

While the high eradication rate is promising, the lack of detailed safety data and the presence of publication bias warrant a conservative approach. Clinicians should consider local resistance patterns and individual patient factors when selecting regimens, rather than relying solely on this pooled estimate.