Is there a role for doxycycline in a regimen for the eradication of Helicobacter pylori (H. pylori) infection? A systematic review and meta-analysis

Microb Health Dis 2026; 8 : e1516
DOI: 10.26355/mhd_20264_1516

  Topic: Helicobacter pylori     Category:

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Abstract

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.

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To cite this article

Is there a role for doxycycline in a regimen for the eradication of Helicobacter pylori (H. pylori) infection? A systematic review and meta-analysis

Microb Health Dis 2026; 8 : e1516
DOI: 10.26355/mhd_20264_1516

Publication History

Submission date: 16 Mar 2026

Revised on: 25 Mar 2026

Accepted on: 30 Mar 2026

Published online: 30 Apr 2026