Background Helicobacter pylori eradication rates achieved with clarithromycin-based triple therapies are declining due to antibiotic resistance, but data regarding temporal changes in efficacy with these eradication therapies are scarce. Objective To evaluate the efficacy of clarithromycin-based triple eradication regimens over time. Design A comprehensive literature review and time-trend analysis. Data sources and methods Bibliographies of recently published systematic literature reviews were searched and supplemented with a targeted literature review conducted using Medline and Embase databases and ProQuest from conception to May 2021. Studies reporting H. pylori eradication rates of clarithromycin-based triple therapies were included and temporal trends were estimated using a random-effects model. Results Eradication rates for triple therapies containing proton pump inhibitors (PPIs), clarithromycin, and amoxicillin showed a significant decline over the past 23 years (p = 0.0315). However, this decline was not significant when eradication rates achieved with vonoprazan-based triple therapy were included (p = 0.3910). Conclusion Vonoprazan-based triple therapy partially mitigated the decline in eradication rates seen with PPI-based triple therapy, likely due to more powerful acid suppression of vonoprazan.

中文翻译：

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简短交流：以克拉霉素为基础的方案治疗幽门螺杆菌感染疗效的全球时间趋势。

背景 由于抗生素耐药性，基于克拉霉素的三联疗法实现的幽门螺杆菌根除率正在下降，但有关这些根除疗法疗效随时间变化的数据却很少。目的 评估以克拉霉素为基础的三联根除方案随时间推移的疗效。设计 全面的文献综述和时间趋势分析。数据来源和方法检索了最近发表的系统文献综述的参考书目，并补充了从受孕到 2021 年 5 月使用 Medline 和 Embase 数据库以及 ProQuest 进行的有针对性的文献综述。报告了基于克拉霉素的三联疗法的幽门螺杆菌根除率的研究被纳入其中，使用随机效应模型估计时间趋势。结果 过去 23 年中，包含质子泵抑制剂 (PPI)、克拉霉素和阿莫西林的三联疗法的根除率显着下降 (p = 0.0315)。然而，当包括基于沃诺拉赞的三联疗法实现的根除率时，这种下降并不显着（p = 0.3910）。结论 基于沃诺拉赞的三联疗法部分缓解了基于 PPI 的三联疗法根除率的下降，这可能是由于沃诺拉赞更强的酸抑制作用。