IS THERE A ROLE FOR DOXYCYCLINE IN A REGIMEN FOR ERADICATION OF HELICOBACTER PYLORI (H. PYLORI) INFECTION? A SYSTEMATIC REVIEW AND META-ANALYSIS

Objectives: Half of the world’s population is infected with H. pylori, with higher prevalence in developing countries. H. pylori infection is associated with peptic ulcer disease, gastric adenocarcinoma, and gastric lymphoma; therefore, eradication is recommended in all diagnosed cases. We consider that successful eradication should exceed 90-95%, and for this, an efficient therapy including several antibiotics and a proton pump inhibitor is needed. Our study aims to assess the efficacy of doxycycline-containing regimens for H. pylori eradication. Materials and Methods: English medical literature searches were conducted up to December 31, 2025. Searches focused on regimens containing doxycycline for the eradication of H. pylori in comparison with regimens without doxycycline. A meta-analysis was performed using Comprehensive Meta-analysis software (Version 4, Biostat Inc., Englewood, NJ, United States). Pooled odds ratios (ORs) and 95% confidence intervals (95% CIs) were calculated using a random-effects model. Heterogeneity was assessed using the Cochran Q test and the I² statistic. Potential publication bias was evaluated using funnel plots and statistical tests. Results: We included 3 articles and 8 sub-studies in our meta-analysis that examined eradication rates of different regimens and compared doxycycline-based to non-doxycycline-based regimens, published up to December 31, 2025. The random-effects model was employed for the analysis. Doxycycline-based regimens were inferior to other regimens, with a mean OR for successful eradication of 0.641 (95% CI: 0.452 to 0.909; p = 0.013). Conclusions: This systematic review and meta-analysis confirmed that doxycycline-based therapeutic regimens are less effective for H. pylori eradication than the other regimens studied.