Levofloxacin-based triple therapy in first-line treatment for Helicobacter pylori eradication

Maria Assunta Zocco, Veronica Ojetti, Cristiano Spada, Giovanni Cammarota, Giovanni Battista Gasbarrini, Antonio Gasbarrini, Marcello Candelli, Filippo Cremonini, Rosalba Finizio, Ec Nista

Risultato della ricerca: Contributo in rivistaArticolo in rivista

72 Citazioni (Scopus)

Abstract

BACKGROUND: The standard first-line therapies for Helicobacter pylori eradication are based on clarithromycin and amoxicillin or metronidazole. Recent studies suggested levofloxacin as an alternative option for both first-and second-line H. pylori eradication treatment. AIMS: To compare efficacy and tolerability of two different 7-day standard triple therapies versus 7-day levofloxacin-based triple therapy in first-line treatment for H. pylori infection. METHODS: Three hundred consecutive H. pylori positive patients were randomized to receive: clarithromycin, amoxicillin, esomeprazole (Group A: N = 100); clarithromycin, metronidazole, esomeprazole (Group B: N = 100); or clarithromycin, levofloxacin, esomeprazole (Group C: N = 100). H. pylori status was rechecked by (13)C urea breath test 6 wk after the end of therapy. RESULTS: Sixteen out of 300 patients discontinued treatment because of the occurrence of side effects (Group A, 5; Group B, 7; Group C, 4). The eradication rates in intention to treat (ITT) and per protocol (PP) analyses were: Group A, 75% and 79%; Group B, 72% and 77.4%; and Group C, 87% and 90.6%. The eradication rate achieved with levofloxacin-based triple therapy was significantly higher than that with standard therapies in either ITT (87%vs 75%, p <0.05; 87%vs 72%, p <0.01;) or PP analysis (90.6%vs 79%, p <0.05; 90.6 vs 77.4, p <0.05). No difference was found between standard triple therapies. The incidence of side effects was similar among groups. CONCLUSIONS: A 7-day levofloxacin-based triple therapy can achieve higher H. pylori eradication rates than standard regimens. These data suggest levofloxacin-based regimens can be the most effective in first-line anti-H. pylori therapy, at least in the Italian population.
Lingua originaleEnglish
pagine (da-a)1985-1990
Numero di pagine6
RivistaAmerican Journal of Gastroenterology
Volume101
DOI
Stato di pubblicazionePubblicato - 2006

Keywords

  • Adolescent
  • Adult
  • Aged
  • Anti-Bacterial Agents
  • Biopsy
  • Clarithromycin
  • Drug Therapy, Combination
  • Endoscopy, Gastrointestinal
  • Enzyme Inhibitors
  • Female
  • Follow-Up Studies
  • Gastric Mucosa
  • Gastritis
  • Helicobacter Infections
  • Helicobacter pylori
  • Humans
  • Male
  • Metronidazole
  • Middle Aged
  • Ofloxacin
  • Omeprazole
  • Prospective Studies
  • Treatment Outcome

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