{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,30]],"date-time":"2026-08-30T15:51:44Z","timestamp":1788105104126,"version":"build-2803163510"},"reference-count":34,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,5,16]],"date-time":"2026-05-16T00:00:00Z","timestamp":1778889600000},"content-version":"vor","delay-in-days":15,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Helicobacter"],"published-print":{"date-parts":[[2026,5]]},"abstract":"ABSTRACT<\/jats:title>\n \n Objectives<\/jats:title>\n \n Bismuth\u2010containing quadruple therapy (BQT) is recommended for\n \n H. pylori<\/jats:italic>\n <\/jats:styled-content>\n rescue treatment, but many patients cope with pill burden and adverse events. High\u2010dose dual therapy (HDDT) may be easier to tolerate. We compared HDDT with BQT in rescue therapy.\n <\/jats:p>\n <\/jats:sec>\n \n Materials and Methods<\/jats:title>\n \n We followed\n PRISMA<\/jats:styled-content>\n 2020 (\n PROSPERO CRD420251266898<\/jats:styled-content>\n ) and searched\n PubMed<\/jats:styled-content>\n \/\n MEDLINE<\/jats:styled-content>\n , Embase, Cochrane\n CENTRAL<\/jats:styled-content>\n , Web of Science Core Collection,\n CiNii<\/jats:styled-content>\n Research, and Major Chinese Databases (\n CNKI<\/jats:styled-content>\n , Wanfang Data, and\n VIP<\/jats:styled-content>\n ) through December 16, 2025. We pooled head\u2010to\u2010head rescue\n RCTs<\/jats:styled-content>\n comparing\n HDDT<\/jats:styled-content>\n (\n PPI<\/jats:styled-content>\n \/\n PCAB<\/jats:styled-content>\n + Amoxicillin \u2265\u20093\u2009g\/Day, \u2265\u2009\n TID<\/jats:styled-content>\n ) with\n BQT<\/jats:styled-content>\n using random\u2010effects models. risk of bias was assessed with\n RoB<\/jats:styled-content>\n 2 and certainty with\n GRADE<\/jats:styled-content>\n .\n TSA<\/jats:styled-content>\n assessed information size for the primary\n ITT<\/jats:styled-content>\n outcome.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Ten RCTs (\n n<\/jats:italic>\n \u2009=\u20092407) showed comparable ITT eradication for HDDT vs. BQT (79.9% vs. 79.9%, RR 1.01, 95% CI 0.97\u20131.05;\n I<\/jats:italic>\n 2<\/jats:sup>\n \u2009=\u20093.9%). Any adverse events were less frequent with HDDT (122\/1135, 10.7%) than BQT (334\/1123, 29.7%). The corresponding meta\u2010analysis (expressed as AE\u2010free so that RR >\u20091 favors HDDT) showed RR 1.27, 95% CI 1.15\u20131.41. TSA suggested that the required information size for the primary ITT outcome was reached, making a clinically important (\u2265\u200910%) relative difference in ITT eradication unlikely.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n In rescue patients without penicillin allergy, HDDT achieves eradication comparable to BQT while causing far fewer adverse events. HDDT is a practical rescue option when BQT is poorly tolerated, although most evidence comes from China and reporting of adherence and resistance is uneven.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/hel.70133","type":"journal-article","created":{"date-parts":[[2026,5,16]],"date-time":"2026-05-16T08:46:31Z","timestamp":1778921191000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["High\u2010Dose Dual Therapy Versus Bismuth\u2010Containing Quadruple Therapy as Rescue Treatment for\n Helicobacter pylori<\/i>\n Infection: Systematic Review and Meta\u2010Analysis"],"prefix":"10.1111","volume":"31","author":[{"given":"Liang","family":"Zhang","sequence":"first","affiliation":[{"name":"The First Hospital of Tsinghua University Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jian","family":"Liu","sequence":"additional","affiliation":[{"name":"The First Hospital of Tsinghua University Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Da","family":"Li","sequence":"additional","affiliation":[{"name":"The First Hospital of Tsinghua University Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-9162-447X","authenticated-orcid":false,"given":"Yali","family":"Wang","sequence":"additional","affiliation":[{"name":"The First Hospital of Tsinghua University Beijing 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