BACKGROUND: The effectiveness of standard triple therapy(STT) for the eradication of Helicobacter pylori(HP) has decreased recently.Sequential therapy(SQT) is a new regimen proposed to address this problem.OBJECTIVE: To compare the efficacy of SQT versus STT for HP eradication.METHODS: We performed a systematic review of the literature and pooled-data analysis.The eradication rates were based on an intention-to-treat(ITT) and per-protocol(PP) basis.The risk ratios(RR) of eradication rate were pooled,with a 95%CI.RESULTS: A total of 33 trials met the inclusion criteria.The ITT and PP eradication rates were 80.4% and 88.7% in SQT,and 74.9% and 78.6% in STT,respectively.The RR for eradication of HP with SQT compared with STT was 1.14 (95% CI: 1.09–1.18) for ITT analysis and 1.14 (95% CI: 1.10–1.19) for PP analysis.There was significant heterogeneity between trial results (I2=72%,P<0.0001).Subgroup analyses showed that SQT was superior to both 7-day and 10-day STT,but was not significantly better than 14-day STT.There were no significant differences between groups in terms of the risk of adverse effects.CONCLUSIONS: SQT is more efficacious than STT (7-day and 10-day) in the eradication of HP,but the pooled rate seemed suboptimal.Further research is needed to develop more effective therapeutic approaches,regional monitoring of resistance rates should performed to help guide treatment.