Doxycycline in Eradication Therapy of <b><i>Helicobacter pylori</i></b> - A Systematic Review and Meta-Analysis

<b><i>Background:</i></b> Since resistance of <i>Helicobacter pylori</i> is developing very fast all over the world, new treatment regimens for eradication are urgently needed. <b><i>Aim:</i></b> To compare eradication success rate of <i>H. pylori</i> treatment regimens with and without doxycycline. <b><i>Methods:</i></b> English medical literature searches were conducted for regimens including doxycycline for eradication of <i>H. pylori</i>. Searches were performed up to August 31, 2015, using MEDLINE, PubMed, EMBASE, Scopus and CENTRAL. Meta-analysis was performed by using comprehensive meta-analysis software. Pooled ORs and 95% CIs were calculated comparing treatment regimens for eradication of <i>H. pylori</i> infection with and without doxycycline. <b><i>Results:</i></b> The OR for eradication success rate in a fixed model was in favor for treatment regimens with doxycycline: 1.292, 95% CI 1.048-1.594, p = 0.016. There was no significant heterogeneity in the included studies: Q = 15.130, d.f. (Q) = 8, I² = 47.126, p > 0.10. When treatment regimens with doxycycline were compared only with treatment regimens with tetracycline, no significant difference was found in eradication success rate: OR 0.95, 95% CI 0.68-1.32, p = 0.77. But when treatment regimens with doxycycline were compared with treatment regimens without tetracycline, the OR in favor of doxycycline was even higher: OR 1.59, 95% CI 1.21-2.09, p < 0.001. <b><i>Conclusion:</i></b> In this meta-analysis, we confirmed doxycycline efficiency in the eradication of <i>H. pylori</i>. Thus, triple, quadruple or even high dose dual therapy with regimens containing doxycycline should be considered.