Primary antibiotic resistance in Helicobacter pylori in China: a systematic review and meta-analysis
Abstract
BACKGROUND
The incidence of Helicobacter pylori (HP) is 25% - 50% in developed countries, and 80% in developing countries, including 56.2% in China. However, antibiotic resistance of HP is a threat to the HP control. The purpose of this study is to comprehensively evaluate primary drug resistance of HP in China.
METHODS
The full text reported primary antibiotic resistance prevalence of HP from multiple databases (PubMed, Web of science, Evimed (www.evimed.com), Cochrane library and China National Knowledge Internet (CNKI)). Review Manager 5.2 was adopted for meta-analysis, sensitivity analysis and bias analysis. Newcastle-Ottawa Scale (NOS scale) was used to assess the article quality.
RESULTS
In this research, 38804 HP samples from 22 trials were extracted. The results suggested that overall prevalence of amoxicillin (AMO) resistance of HP in the adults was (Mean difference (MD)=1.35%, 95%CI [1.03%, 1.68%]), HP clarithromycin (CLA) resistance was (MD=23.76%, 95%CI [20.23%, 27.3%]), metronidazole (MTZ) resistance was (MD=69.32% with 95%CI [64.85%, 73.8%]) and HP levofloxacin (LEV) resistance was (MD = 29.45% with 95%CI[4.90, 176.96]). From the results of sensitivity and publication bias, we find that these results are robust and had little publication bias.
CONCLUSION
Our research showed that in China the prevalence of primary antibiotic for HP was needed attention, especially metronidazole, levofloxacin and clarithromycin.
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid.
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