Comparison of 7- and 14-day first-line therapies including levofloxacin in patients with Helicobacter pylori positive non-ulcer dyspepsia

Erçin, Cemal Nuri; Uygun, Ahmet; Toros, Ahmet Burak; Kantarcıoğlu, Murat; Kılcıler, Güldem; Polat, Zülfıkar; Bağcı, Sait

doi:10.4318/tjg.2010.0041

Cited by 22 publications

(13 citation statements)

References 36 publications

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“…Only one RCT compared two durations for levofl oxacin triple salvage treatment; Di Caro et al ( 186 ) compared two types of 10-day and two types of 7-day PAL regimens in Italy and found signifi cantly higher effi cacy with longer duration (88% vs. 78%). Th is fi nding was confi rmed by an RCT from Turkey which reported signifi cantly higher effi cacy with longer duration of PAL as fi rst-line treatment (72% with 14-day regimen vs. 34% with 7-day regimen) ( 189 ).…”

Section: Levofl Oxacin Triple Regimen (Ppi Amoxicillin Levofl Oxacimentioning

confidence: 90%

ACG Clinical Guideline: Treatment of Helicobacter pylori Infection

Chey

Leontiadis

Howden

et al. 2017

American Journal of Gastroenterology

1,316

1,505

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Helicobacter pylori ( H. pylori ) infection is a common worldwide infection that is an important cause of peptic ulcer disease and gastric cancer. H. pylori may also have a role in uninvestigated and functional dyspepsia, ulcer risk in patients taking low-dose aspirin or starting therapy with a non-steroidal anti-infl ammatory medication, unexplained iron defi ciency anemia, and idiopathic thrombocytopenic purpura. While choosing a treatment regimen for H. pylori , patients should be asked about previous antibiotic exposure and this information should be incorporated into the decision-making process. For fi rst-line treatment, clarithromycin triple therapy should be confi ned to patients with no previous history of macrolide exposure who reside in areas where clarithromycin resistance amongst H. pylori isolates is known to be low. Most patients will be better served by fi rst-line treatment with bismuth quadruple therapy or concomitant therapy consisting of a PPI, clarithromycin, amoxicillin, and metronidazole. When fi rst-line therapy fails, a salvage regimen should avoid antibiotics that were previously used. If a patient received a fi rst-line treatment containing clarithromycin, bismuth quadruple therapy or levofl oxacin salvage regimens are the preferred treatment options. If a patient received fi rst-line bismuth quadruple therapy, clarithromycin or levofl oxacin-containing salvage regimens are the preferred treatment options. Details regarding the drugs, doses and durations of the recommended and suggested fi rst-line and salvage regimens can be found in the guideline. Asia and Central and South America ( 8,22 ). Th ere is, however, preliminary evidence that it may be falling in some previously high prevalence areas ( 22 ). People immigrating to North America from Asia and other parts of the world have a much higher prevalence of the infection than people born in North America ( 23 ). In one study, the seroprevalence among immigrants from East Asia was 70.1% ( 24 ). Hispanic immigrants to North America have higher rates of the infection than fi rst-or second-generation Hispanics who were born here ( 25 ). QUESTION 2: WHAT ARE THE INDICATIONS TO TEST FOR, AND TO TREAT, H. PYLORI INFECTION? RecommendationsSince all patients with a positive test of active infection with H. pylori should be off ered treatment, the critical issue is which patients should be tested for the infection (strong recommendation, quality of evidence: not applicable), All patients with active peptic ulcer disease (PUD), a past history of PUD (unless previous cure of H. pylori infection has been documented), low-grade gastric mucosa-associated lymphoid tissue (MALT) lymphoma, or a history of endoscopic resection of early gastric cancer (EGC) should be tested for H. pylori infection. Th ose who test positive should be off ered treatment for the infection (strong recommendation, quality of evidence: high for active or history of PUD, low for MALT lymphoma, low for history of endoscopic resection of EGC).In patients with uninvestigated d...

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Section: Levofl Oxacin Triple Regimen (Ppi Amoxicillin Levofl Oxacimentioning

confidence: 90%

ACG Clinical Guideline: Treatment of Helicobacter pylori Infection

Chey

Leontiadis

Howden

et al. 2017

American Journal of Gastroenterology

1,316

1,505

View full text Add to dashboard Cite

show abstract

“…With respect to the duration of the quinolone regimens, 3 meta-analyses [10][11][12] found, as did 2 recent randomized clinical trials [15,49], higher cure rates with 10-day than with 7-day levofloxacin-containing regimens. Furthermore, a very recent study has compared the efficacy of 14-day and 10-day levofloxacincontaining triple therapy as second-line regimen, and a higher eradication rate was demonstrated with the longest regimen (85% vs. 68%) [50]; this study suggests that long-term (e.g.…”

Section: Discussionmentioning

confidence: 94%

Two-week, high-dose proton pump inhibitor, moxifloxacin triple Helicobacter pylori therapy after failure of standard triple or non-bismuth quadruple treatments

Gisbert¹,

Romano²,

Molina–Infante³

et al. 2015

Digestive and Liver Disease

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“…Because fluoroquinolones are commonly used in Turkey for treating respiratory and genitourinary tract infections, levofloxacin resistance is increasing in Turkey. A Turkish study on sevenday levofloxacin-based triple therapy showed eradication rates of 34.1%-68% while those with 14-day therapy varied between 60.5 and 86.3% [24,26,36]. Changes in dosage, duration of therapy, drug interactions, and physical characteristics of patients may affect eradication rates.…”

Section: Discussionmentioning

confidence: 99%