A systematic review of Helicobacter pylori eradication treatment schedules in children

CRD COMMENTARY: This review addressed a specific question with adequate inclusion and exclusion criteria. The literature search was fairly comprehensive although a greater number of databases could have been searched. The failure to include abstracts before 1997 and the language restrictions imposed may have resulted in some publication bias. It was not stated how many reviewers selected the studies and extracted the data, so it is possible there was some reviewer bias. All types of studies were eligible for inclusion in the review. No information was provided on the design of the included studies, and there was no validity or quality assessment. It appears that all the included studies were uncontrolled and unblinded, and consequently of very poor quality. The study details presented were limited; in particular, the children's ages were not reported. The pooling of the studies appeared appropriate; only studies of the same drug combinations were pooled. The effect of treatment duration on the eradication rates may have been masked by the pooled results, although this was explored for some drug combinations. The authors' conclusions were generally supported by the results presented in the review. However, those concerning treatment duration were too pronounced given the weakness of the evidence upon which they were based.