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The decreasing efficacy of H. pylori eradication treatments over time makes the search for better regimens and adjuvant medications a priority.

To conduct a meta‐analysis of studies comparing rabeprazole or esomeprazole with other proton pump inhibitors (PPI) or with each other in H. pylori eradication treatment.

Selection of Studies: Randomised clinical trials comparing esomeprazole or rabeprazole with first‐generation PPIs (omeprazole‐lansoprazole‐pantoprazole) or with each other.

The meta‐analysis (35 studies, 5998 patients) showed higher eradication rates for esomeprazole than for first‐generation PPIs: 82.3% vs. 77.6%; OR = 1.32(1.01–1.73); NNT = 21. Rabeprazole also showed better results than first‐generation PPIs: 80.5% vs. 76.2%; OR = 1.21(1.02–1.42); NNT = 23. PPI dosage sub‐analysis: only esomeprazole 40 mg b.d. improved results [83.5 …