BACKGROUND: Sequential therapy is a first-line regimen obtaining satisfactory @entity1534 eradication. @entity1162 improves the success rate even if a recent meta-analysis showed satisfying results only for the 14-day regimen. Studies from Africa and North America were unavailable in previous meta-analyses. AIM: To perform a meta-analysis comparing sequential vs. prolonged 14-day triple therapy with regard to 'geographic weighting' by considering subgroups analysis according to @entity868 / @entity4581 low and high resistance areas. METHODS: Based on PRISMA recommendations, we considered all first-line clinical studies from 2003 to November 2014. Randomised clinical trials (RCTs) were included by a search on PubMed, MEDLINE, Science Direct, EMBASE. Data on eradication rates were expressed as ITT. Risk ratio (RR), pooled RR and 95% confidence intervals were calculated by the Mantel-Haenszel method. Data were entered into RevMan 5.2 software (Nordic Cochrane Centre) using a random-effects model. RESULTS: Databases identified 194 studies; seven met the inclusion criteria. Overall results showed a similar effectiveness of the two regimens considered (RR = 0.99; 95% CI = 0.94-1.05; p = 0.75). In areas with high resistance to @entity4581 , sequential was superior to 14-day triple therapy (RR = 0.95; 95% CI = 0.90-1.00; p = 0.03). In areas with high @entity868 resistance, sequential and 14-day triple therapy were equivalent (RR = 0.99; 95% CI = 0.91-1.08; p = 0.82). CONCLUSIONS: 'Geographic weighting' could be the main factor affecting the lack of differences between sequential and 14-day triple therapy outcomes.

Sequential vs. prolonged 14-day triple therapy for XXXX eradication: the meta-analysis may be influenced by 'geographical weighting'.

@entity1162 :: ('MESH:D008133', 'Disease') :: ['Triple therapy prolongation'] @entity4581 :: ('MESH:D017291', 'Chemical') :: ['clarithromycin'] @entity868 :: ('MESH:D008795', 'Chemical') :: ['metronidazole'] @entity1534 :: ('210', 'Species') :: ['Helicobacter pylori']
@entity1534 :: (210,Species) :: ['Helicobacter pylori']
