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Not all the susceptibility-guided therapies for Helicobacter pylori (H.pylori) infection achieve excellent eradication rates. The aim of this study was to perform a systematic review and meta-analysis to identify the optimal regimen for H.pylori treatment based on antibiotic susceptibility. A systematic search was performed in multiple databases. Studies reporting eradication rates of H.pylori with susceptibility-guided therapies were selected. Meta-analysis was conducted to calculate the pooled eradication rate among the treatment regim