{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T18:11:04Z","timestamp":1787508664239,"version":"build-2736575974"},"reference-count":76,"publisher":"Maad Rayan Publishing Company","issue":"3","content-domain":{"domain":["mejdd.org"],"crossmark-restriction":false},"short-container-title":["Middle East J Dig Dis"],"published-print":{"date-parts":[[2024,7,31]]},"abstract":"<jats:p>Background: Helicobacter pylori, the most prevalent infection in the world, has great importance due to being related to peptic ulcer disease, gastric metaplasia, dysplasia, and even gastric adenocarcinoma or mucosa-associated lymphoid tissue (MALT) lymphoma. The standard H. pylori eradication regimen is based on antibiotic susceptibility testing. If susceptibility testing is not available, a standard treatment regimen will be recommended based on records of H. pylori resistance rates to antibiotics in a region or locally proven highly effective regimens (equal to or higher than 90% eradication rate). The aim of this review was to define suitable recommendations for local treatment in different cities of Iran. Methods: This review article consists of randomized controlled trials related to H. pylori eradication in Iran. Data including the kind of therapy, number of patients and per-protocol H. pylori eradication rates were recorded in data gathering forms. Data search was conducted in PubMed and Google Scholar databases from 2018 to December 2023. Results: According to our review of Iranian articles regarding first-line H. pylori eradication regimens, these treatment protocols could be recommended: Bismuth-clarithromycin quadruple therapy in Ardabil, bismuth-clarithromycin quadruple therapy with probiotics in Birjand, standard triple therapy in Ilam, bismuth quadruple therapy or bismuth triple therapy or concomitant regimen in Sari, sequential therapy in Tehran and bismuth quadruple therapy in Yazd. These regimes can be extended to other regions that have a similar situation. According to the reports of Iranian researchers, a quinolone-containing regimen (levofloxacin preferred) is recommended for second-line eradication therapy. Conclusion: Various H. pylori eradication regimens can be used as first-line therapy; however, choices for second-line therapy are limited. We recommend the quinolone-containing regimens as the preferred second-line therapy.<\/jats:p>","DOI":"10.34172\/mejdd.2024.389","type":"journal-article","created":{"date-parts":[[2024,10,8]],"date-time":"2024-10-08T04:32:34Z","timestamp":1728361954000},"page":"147-154","update-policy":"https:\/\/doi.org\/10.34172\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["An Update on Eradication of\n                    <i>Helicobacter Pylori<\/i>\n                    in Iran: A Review"],"prefix":"10.34172","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5473-282X","authenticated-orcid":true,"given":"Mahboobe","family":"Ebrahimi","sequence":"first","affiliation":[{"name":"Gut and Liver Research Center, Non-communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sepehr","family":"Tirgar Fakheri","sequence":"additional","affiliation":[{"name":"Gut and Liver Research Center, Non-communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Faezeh","family":"Aeeni","sequence":"additional","affiliation":[{"name":"General Physician, Private Clinic, Sari, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tarang","family":"Taghvaei","sequence":"additional","affiliation":[{"name":"Gut and Liver Research Center, Non-communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mehdi","family":"Saberi Firoozi","sequence":"additional","affiliation":[{"name":"Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0579-6111","authenticated-orcid":true,"given":"Hafez","family":"Fakheri","sequence":"additional","affiliation":[{"name":"Gut and Liver Research Center, Non-communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"20123","published-online":{"date-parts":[[2024,7,31]]},"reference":[{"key":"R1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2022-327745"},{"key":"R2","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2020-322368"},{"key":"R3","doi-asserted-by":"publisher","DOI":"10.1007\/s00535-019-01559-9"},{"key":"R4","doi-asserted-by":"publisher","DOI":"10.1007\/s10120-017-0688-7"},{"key":"R5","doi-asserted-by":"publisher","DOI":"10.34172\/hpp.2023.15"},{"key":"R6","doi-asserted-by":"crossref","first-page":"187","DOI":"10.54319\/jjbs\/140124","article-title":"Prevalence of Helicobacter pylori and Its seasonality in Ilam, Iran","volume":"14","author":"Hemati S","year":"2021","journal-title":"Jordan J Biol Sci"},{"key":"R7","doi-asserted-by":"crossref","first-page":"183","DOI":"10.30699\/ijp.2017.25037","article-title":"Sero-prevalence of Helicobacter pylori Infection in Neyshabur, Iran, During 2010-2015","volume":"12","author":"Salehi M","year":"2017","journal-title":"Iran J Pathol"},{"key":"R8","doi-asserted-by":"publisher","DOI":"10.22034\/ncm.2022.140810"},{"key":"R9","first-page":"31","article-title":"Prevalence of Helicobacter pylori infection in Sari Northern Iran; a population-based study","volume":"12","author":"Maleki I","year":"2019","journal-title":"Gastroenterol Hepatol Bed Bench"},{"key":"R10","doi-asserted-by":"publisher","DOI":"10.34172\/ajcmi.2022.09"},{"key":"R11","doi-asserted-by":"publisher","DOI":"10.30483\/rijm.2022.254308.1139"},{"key":"R12","doi-asserted-by":"publisher","DOI":"10.34172\/mejdd.2022.285"},{"key":"R13","doi-asserted-by":"publisher","DOI":"10.4103\/2008-7802.177893"},{"key":"R14","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2016-312288"},{"key":"R15","doi-asserted-by":"publisher","DOI":"10.3390\/microorganisms9102033"},{"key":"R16","doi-asserted-by":"publisher","DOI":"10.3390\/cells10092191"},{"key":"R17","doi-asserted-by":"publisher","DOI":"10.1016\/j.imr.2016.05.005"},{"key":"R18","doi-asserted-by":"publisher","DOI":"10.1186\/s13098-021-00765-x"},{"key":"R19","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2022.833424"},{"key":"R20","doi-asserted-by":"publisher","DOI":"10.1111\/hel.12330"},{"key":"R21","doi-asserted-by":"publisher","DOI":"10.4103\/joacc.JOACC_46_19"},{"key":"R22","doi-asserted-by":"crossref","unstructured":"Siddiqua T, Alam MN, Ahmad SM, Haque R, Ahmed T, Allen L, et al. Helicobacter pylori infection and vitamin B12 deficiency during early pregnancy in an urban slum in Bangladesh (P24-035-19). Curr Dev Nutr 2019;3(Suppl 1):nzz044.P24-35-19. doi: 10.1093\/cdn\/nzz044.P24-035-19.","DOI":"10.1093\/cdn\/nzz044.P24-035-19"},{"key":"R23","doi-asserted-by":"publisher","DOI":"10.1093\/pcmedi\/pbz009"},{"key":"R24","doi-asserted-by":"publisher","DOI":"10.22034\/apjcp.2018.19.3.591"},{"key":"R25","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.33678"},{"key":"R26","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2021-324032"},{"key":"R27","doi-asserted-by":"publisher","DOI":"10.1159\/000149716"},{"key":"R28","doi-asserted-by":"publisher","DOI":"10.1038\/s41575-021-00449-x"},{"key":"R29","doi-asserted-by":"publisher","DOI":"10.5009\/gnl220429"},{"key":"R30","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2036.2001.00974.x"},{"key":"R31","doi-asserted-by":"publisher","DOI":"10.7717\/peerj.15121"},{"key":"R32","doi-asserted-by":"publisher","DOI":"10.1111\/hel.12730"},{"key":"R33","doi-asserted-by":"publisher","DOI":"10.1089\/mdr.2014.0081"},{"key":"R34","doi-asserted-by":"publisher","DOI":"10.3390\/jcm8112004"},{"key":"R35","doi-asserted-by":"publisher","DOI":"10.1097\/mog.0000000000000981"},{"key":"R36","first-page":"301","article-title":"Acid, protons and Helicobacter pylori","volume":"69","author":"Sachs G","year":"1996","journal-title":"Yale J Biol Med"},{"key":"R37","doi-asserted-by":"publisher","DOI":"10.1177\/17562848231160858"},{"key":"R38","doi-asserted-by":"publisher","DOI":"10.1016\/0016-5085(92)90095-g"},{"key":"R39","doi-asserted-by":"publisher","DOI":"10.15171\/mejdd.2017.84"},{"key":"R40","doi-asserted-by":"publisher","DOI":"10.1186\/s12941-023-00582-2"},{"key":"R41","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2008.10.024"},{"key":"R42","doi-asserted-by":"crossref","unstructured":"Fallone CA, Chiba N, van Zanten SV, Fischbach L, Gisbert JP, Hunt RH, et al. The Toronto consensus for the treatment of Helicobacter pylori infection in adults. Gastroenterology 2016;151(1):51-69.e14. doi: 10.1053\/j.gastro.2016.04.006.","DOI":"10.1053\/j.gastro.2016.04.006"},{"key":"R43","doi-asserted-by":"publisher","DOI":"10.4103\/jfmpc.jfmpc_1035_22"},{"key":"R44","first-page":"172","article-title":"Efficacy of 14-day concomitant quadruple therapy and 14-day high-dose dual therapy on H pylori eradication","volume":"15","author":"Yadollahi B","year":"2022","journal-title":"Gastroenterol Hepatol Bed Bench"},{"key":"R45","doi-asserted-by":"publisher","DOI":"10.1007\/s12664-018-0916-z"},{"key":"R46","unstructured":"Tirgar Fakheri S, Sadough A, Fakheri H. Comparing clarithromycin- and levofloxacin-containing triple therapies for first line Helicobacter pylori eradication Mazandran province, Iran. J Mazandaran Univ Med Sci 2019;29(176):1-9. [Persian]."},{"key":"R47","doi-asserted-by":"publisher","DOI":"10.18502\/acta.v57i4.1841"},{"key":"R48","doi-asserted-by":"publisher","DOI":"10.22088\/cjim.14.4.676"},{"key":"R49","doi-asserted-by":"publisher","DOI":"10.22088\/cjim.14.4.68"},{"key":"R50","doi-asserted-by":"publisher","DOI":"10.4103\/ijp.IJP_719_19"},{"key":"R51","doi-asserted-by":"publisher","DOI":"10.34172\/mejdd.2020.169"},{"key":"R52","first-page":"19","article-title":"Levofloxacin based vs clarithromycin based sequential therapy in Helicobacter pylori eradication; a randomized clinical trial","volume":"11","author":"Moradniani M","year":"2018","journal-title":"Gastroenterol Hepatol Bed Bench"},{"key":"R53","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajg.2022.10.004"},{"key":"R54","doi-asserted-by":"publisher","DOI":"10.34172\/mejdd.2023.314"},{"key":"R55","doi-asserted-by":"publisher","DOI":"10.1186\/s12876-022-02187-z"},{"key":"R56","first-page":"284","article-title":"Comparison of two common quadruple therapy protocols for eradication of Helicobacter pylori in Iran: an open label, randomized, non-inferiority, clinical trial","volume":"25","author":"NikKhah M","year":"2020","journal-title":"Govaresh"},{"key":"R57","first-page":"250","article-title":"Cost-effectiveness analysis of two routine therapeutic methods for Helicobacter pylori eradication: a Persian cohort-based study","volume":"14","author":"Pourfarzi F","year":"2021","journal-title":"Gastroenterol Hepatol Bed Bench"},{"key":"R58","first-page":"57","article-title":"Sequential therapy for Helicobacter pylori eradication with or without bismuth subcitrate","volume":"9","author":"Rafiei R","year":"2021","journal-title":"EC Pharmacol Toxicol"},{"key":"R59","doi-asserted-by":"publisher","DOI":"10.1111\/jgh.14810"},{"key":"R60","doi-asserted-by":"publisher","DOI":"10.14712\/18059694.2020.61"},{"key":"R61","doi-asserted-by":"publisher","DOI":"10.4103\/jrpp.JRPP_19_86"},{"key":"R62","doi-asserted-by":"publisher","DOI":"10.17179\/excli2019-1613"},{"key":"R63","doi-asserted-by":"publisher","DOI":"10.4103\/abr.abr_133_17"},{"key":"R64","doi-asserted-by":"publisher","DOI":"10.15171\/mejdd.2018.117"},{"key":"R65","doi-asserted-by":"publisher","DOI":"10.1111\/hel.13061"},{"key":"R66","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0197096"},{"key":"R67","doi-asserted-by":"publisher","DOI":"10.34172\/mejdd.2021.216"},{"key":"R68","first-page":"146","article-title":"The efficacy and safety of furazolidone-bismuth quadruple therapy for Helicobacter pylori eradication with or without probiotic supplementation","volume":"15","author":"Noorbakhsh N","year":"2022","journal-title":"Gastroenterol Hepatol Bed Bench"},{"key":"R69","doi-asserted-by":"publisher","DOI":"10.1155\/2022\/9794901"},{"key":"R70","first-page":"209","article-title":"Comparison between the two drug regimens of PPI\u2005+\u2005amoxicillin\u2005+\u2005rifampicin and PPI\u2005+\u2005amoxicillin\u2005+\u2005levofloxacin for the treatment of H pylori infections resistant to the first line drug regimen among patients referred to Ilam clinics","volume":"12","author":"Abangah G","year":"2019","journal-title":"Gastroenterol Hepatol Bed Bench"},{"key":"R71","doi-asserted-by":"publisher","DOI":"10.22088\/cjim.10.2.211"},{"key":"R72","first-page":"261","article-title":"The efficacy of levofloxacin-based triple therapy for Helicobacter pylori eradication after failure with clarithromycin-containing regimens","volume":"22","author":"Fakheri H","year":"2018","journal-title":"Govaresh"},{"key":"R73","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2016.563"},{"key":"R74","doi-asserted-by":"publisher","DOI":"10.1111\/hel.12475"},{"key":"R75","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2020.11.059"},{"key":"R76","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v26.i32.4846"}],"container-title":["Middle East Journal of Digestive Diseases"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/mejdd.org\/index.php\/mejdd\/article\/view\/3037\/2369","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/mejdd.org\/index.php\/mejdd\/article\/view\/3037\/2369","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,10,8]],"date-time":"2024-10-08T04:32:46Z","timestamp":1728361966000},"score":1,"resource":{"primary":{"URL":"http:\/\/mejdd.org\/index.php\/mejdd\/article\/view\/3037"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,7,31]]},"references-count":76,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2024,7,31]]}},"URL":"https:\/\/doi.org\/10.34172\/mejdd.2024.389","relation":{},"ISSN":["2008-5249"],"issn-type":[{"value":"2008-5249","type":"print"}],"subject":[],"published":{"date-parts":[[2024,7,31]]},"assertion":[{"value":"Iranian Association of Gastroerterology and Hepatology","name":"journal_owner","label":"Journal Owner"},{"value":"Iranian Association of Gastroerterology and Hepatology","name":"journal_publisher","label":"Journal Publisher"},{"value":"2024-01-14","order":1,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-05-25","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-07-31","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}