Efficacy and safety of antibiotic regimens for Helicobacter pylori eradication: a systematic review and meta-analysis

Background: <0.01). For safety (54 studies, 119 arms, 5,202 events), pooled adverse event incidence was 26.1% (95% CI: 21.0%-31.9%; I²=95.3%). Sequential therapy had the highest incidence (54.1%), dual therapy the lowest (15.8%). Regimens with three antibiotics (52.6%), macrolides (29.0%), or nitroimidazoles (37.1%) were associated with more adverse events. Conclusions Eradication regimens vary in efficacy and safety; treatment selection should balance these factors. Findings require confirmation due to high heterogeneity and between-study comparisons. Systematic review registration: CRD420251207695, https://www.crd.york.ac.uk/PROSPERO/view/CRD420251207695.