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P-CABs Outperform PPIs in Clarithromycin-Resistant H. pylori

This meta-analysis quantifies the eradication advantage of potassium-competitive acid blocker (P-CAB)-based regimens over proton pump inhibitor (PPI)-based regimens specifically in documented clarithromycin-resistant Helicobacter pylori (H. pylori) infection, a population where conventional triple therapy routinely fails.
vonoprazantegoprazankeverprazanpotassium-competitive acid blockersproton pump inhibitorsHelicobacter pyloriclarithromycin resistanceeradication therapyamoxicillinbismuth quadruple therapymeta-analysisantimicrobial stewardship Infectious Disease / Antimicrobials

Background Information

P-CABs are more effective than PPIs against resistant Helicobacter pylori.

Clarithromycin-resistant Helicobacter pylori infections are challenging to treat, and finding effective eradication regimens is crucial. P-CAB-based regimens significantly improved eradication rates in resistant infections (74.7% vs 52.7% for PPIs, RR 1.42; 95% CI 1.14-1.76). Further studies are needed to optimize antibiotic combinations and treatment durations. Current evidence supports P-CABs' superiority in resistant infections. P-CABs outperform PPIs in eradication regimens for clarithromycin-resistant Helicobacter pylori.

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Authors: Andreev DN, Khurmatullina AR, Bordin DS, Zaborovsky AV, Sokolov PS, Kucheryavyy YA, Beliy PA, Maev IV

Citation: Andreev DN, Khurmatullina AR, Bordin DS, et al. Efficacy of Potassium-Competitive Acid Blockers Versus Proton Pump Inhibitors in Eradication Regimens for Clarithromycin-Resistant Helicobacter pylori: A Systematic Review and Meta-Analysis. Pathogens (Basel, Switzerland). 2026;15(9). doi:10.3390/pathogens15090986

Article Links: PubMed · Journal / DOI · Free Full Text (PMC)

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