ReviewSmoking Increases the Treatment Failure for Helicobacter pylori Eradication
Section snippets
Selection of Studies
The initial literature search was conducted through PubMed by using the free text search term: (helicobacter pylori) AND (smoking OR smoker OR tobacco) AND (eradication), with the publication period limited up to August 2005. The inclusion criteria for our analysis were: 1) original articles published in English; 2) odds ratios (ORs) available as a measure of association or the number of succeeded and failed cases according to the smoking category; 3) use of the urea breath test or histological
Description of the Studies
The search yielded a total of 134 publications, 36 of which were excluded by screening of their titles. Abstracts of the remaining 98 articles were reviewed, and 59 were retrieved in full for further consideration. We examined all the candidate articles in detail, which resulted in further exclusion of 37 articles. They were excluded because 1) data for ORs or the number of eradication cases according to the smoking category could not be obtained (n = 26); 2) therapies were second line (n = 4);
Discussion
This study shows that smoking increases risk of treatment failure for H. pylori eradication. We also found significant low rate of eradication among smokers. Of 22 studies we selected to examine, 12 studies observed a significant increase in ORs for eradication failure in smokers. Of 13 studies in which we could gain information about difference rate of eradication according to smoking category, 11 studies observed a higher rate of eradication failure in smokers compared with nonsmokers. The
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This work was supported in part by a Grant-in-Aid for Cancer Research (17-1) from the Ministry of Health, Labour and Welfare, Tokyo, Japan.