Smoking increases the treatment failure for Helicobacter pylori eradication

Takeshi Suzuki, Keitaro Matsuo, Hidemi Ito, Akira Sawaki, Kaoru Hirose, Kenji Wakai, Shigeki Sato, Tsuneya Nakamura, Kenji Yamao, Ryuzo Ueda, Kazuo Tajima

Research output: Contribution to journalReview articlepeer-review

158 Citations (Scopus)


PURPOSE: Treatment failure for Helicobacter pylori (H. pylori) eradication is encountered in approximately 10-20% of patients, and many studies have pointed to a link with smoking. To investigate the effects of smoking on eradication outcome, we performed a meta-analysis. METHODS: A PubMed search was performed to retrieve articles published up to August 2005. Pooled odds ratio (OR) and differences rate for H. pylori eradication failure in smokers compared with nonsmokers were used as summary statistics. Meta-regression was used for examining the source of heterogeneity. RESULTS: Twenty-two published studies (5538 patients), which provided information on eradication failure according to smoking status, were included in the analysis. The summary OR for eradication failure among smokers relative to nonsmokers was 1.95 (95% confidence interval [CI]: 1.55-2.45; P <.01). It corresponds with the differences in eradication rates between smokers and nonsmokers (8.4% [95% CI: 3.3-13.5%, P <.01]). Meta-regression analysis demonstrated that a high proportion of nonulcer dyspepsia patients in studies revealed a higher failure rate among smokers, compared with a low proportion of nonulcer dyspepsia. CONCLUSIONS: Our meta-analysis demonstrated that smoking increases the treatment failure rate for H. pylori eradication.

Original languageEnglish
Pages (from-to)217-224
Number of pages8
JournalAmerican Journal of Medicine
Issue number3
Publication statusPublished - 03-2006

All Science Journal Classification (ASJC) codes

  • General Medicine


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