Second-line levofloxacin-based triple schemes for Helicobacter pylori eradication

Simona Di Caro, Francesco Franceschi, Alberto Mariani, F Thompson, D Raimondo, E Masci, A Testoni, E La Rocca, Antonio Gasbarrini

Risultato della ricerca: Contributo in rivistaArticolo in rivista

54 Citazioni (Scopus)


BACKGROUND: The recommended second-line therapy for Helicobacter pylori (H. pylori) eradication is a quadruple regimen that fails in up to 30% of patients. Several recent studies suggest levofloxacin-based triple therapies as an alternative rescue treatment. However, dosage and length of levofloxacin-based regimens have not been established. AIM: To compare the efficacy and tolerability of four second-line levofloxacin-based schemes for H. pylori eradication. METHODS: One hundred and sixty patients (aged 18-70 years, 72 male patients) who were H. pylori positive after standard triple therapies were randomised to receive esomeprazole 20mg b.d. and amoxicillin 1g b.d. plus levofloxacin 500 mg o.d., for 7 or 10 days (Groups A and B) or levofloxacin 500 mg b.d. for 7 days or 10 days (Groups C and D). H. pylori status was assessed by 13-C Urea Breath Test or rapid urease test, before and 6 weeks after therapy. Incidence of side effects was evaluated by a questionnaire. RESULTS: No dropouts were observed. Eradication of H. pylori infection was successful in: 65% of patients in Group A; 90% in Group B; 70% in Group C; 85% in Group D. Based upon duration of treatment, eradication rates were: 67.5% in 7 days groups and 87.5% in 10 days groups (p=0.004). Dosage of levofloxacin did not affect the eradication rates (77.5% both in the once daily and twice daily groups). Mild adverse events were reported overall in 16% of patients (22.5% in 7 days groups; 27.5% in 10 days groups; p=0.58; 12% in the once daily group; 32.5% in the twice daily group; p=0.04). CONCLUSIONS: 10 days levofloxacin-based second-line regimens were effective in curing H. pylori infection in more than 85% of patients with a lower incidence of adverse effects in levofloxacin single-dosage scheme. The 10 days levofloxacin-based regimens were more effective than 7 days course of treatment showing that duration of therapy is the crucial factor affecting eradication rate.
Lingua originaleEnglish
pagine (da-a)480-485
Numero di pagine6
RivistaDigestive and Liver Disease
Stato di pubblicazionePubblicato - 2009


  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Amoxicillin
  • Anti-Bacterial Agents
  • Anti-Ulcer Agents
  • Breath Tests
  • Dose-Response Relationship, Drug
  • Drug Administration Schedule
  • Drug Therapy, Combination
  • Female
  • Helicobacter Infections
  • Helicobacter pylori
  • Humans
  • Male
  • Middle Aged
  • Ofloxacin
  • Omeprazole
  • Salvage Therapy
  • Young Adult


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