Efficacy and Safety of Antofloxacin-Based Triple Therapy for Helicobacter pylori Eradication Failure in China

He, Xiangjiu; Zeng, Xiang-Peng; Jiang, Chuanshen; Lv, Gang; Li, Dazhou; Wang, Wen

doi:10.1007/s10620-021-06856-z

Cited by 4 publications

(4 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“… 37 And a previous study in our center has shown that the minimum inhibitory concentration (MIC) against all local isolates for levofloxacin was 16 times higher than that for antofloxacin (16.0 µg/ml versus 1.0 µg/ml), and levofloxacin-resistant strains were found in 46.1% of the patients when the MIC of levofloxacin for the strains was ⩾1 µg/ml. 38 We observed that the susceptibility testing of H. pylori as per the gastric biopsy specimen showed antofloxacin resistance of only 2.7% compared to levofoxacin resistance of 32.44%. 7 Besides, the duration of H. pylori therapy must be taken into account.…”

Section: Discussionmentioning

confidence: 71%

“…First, we did not investigate whether S. boulardii mitigated the gastric microbiome disruption caused by H. pylori eradication. Second, in our previous study, 38 the resistance of antibiotics such as antofloxacin to H. pylori was tested, so the resistance of antibiotics related to antofloxacin-based quadruple therapy was not tested again in this study, which may affect the analysis of the H. pylori eradication rate. Third, considering that the effect of S. boulardii adding to treatment for H. pylori eradication is still unclear, further study on this question should be desired, such as the duration of H. pylori therapy, doses and duration of S. boulardii , etc.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

The efficacy and safety of Saccharomyces boulardii in addition to antofloxacin-based bismuth quadruple therapy for Helicobacter pylori eradication: a single-center, prospective randomized-control study

Wang

Sun

et al. 2023

Therap Adv Gastroenterol

Self Cite

View full text Add to dashboard Cite

Background: We previously reported that antofloxacin-based bismuth quadruple therapy was safe and effective for Helicobacter pylori ( H. pylori) eradication. It is not clear whether the addition of Saccharomyces boulardii ( S. boulardii) to antofloxacin-based quadruple therapy can improve the eradication rate of H. pylori and reduce adverse events. Objective: To investigate the effect of adding S. boulardii to antofloxacin-based quadruple therapy on the eradication rate of H. pylori and the adverse events. Design: Single-center, prospective randomized controlled study. Methods: A total of 172 patients with H. pylori infection were randomly assigned to the test and control groups. Patients in the control group ( n = 86) received antofloxacin-based bismuth quadruple therapy for 14 days. On this basis, cases in the test group ( n = 86) received S. boulardii 500 mg b.i.d. The eradication rate of H. pylori and adverse events were observed 4 weeks after the treatment. Results: There were no statistically significant differences in the eradication rates of H. pylori and frequency of diarrhea between the test group and control group ( p > 0.05). The duration of diarrhea in the test group was significantly shorter than in the control group ( p < 0.001). In addition, the two groups exhibited similar adverse event rates for epigastric pain, abdominal distention, dizzy, vomiting, and rash ( p > 0.05). The severity of adverse reactions was similar between the two groups ( p > 0.05), and most of them had mild adverse events. Conclusion: Although the addition of S. boulardii to antofloxacin-based quadruple therapy could not improve the eradication rate of H. pylori, it could shorten the time of antibiotic-associated diarrhea and reduce the incidence of diarrhea. Trial registration number: ChiCTR2200056931.

show abstract

Section: Discussionmentioning

confidence: 71%

Section: Discussionmentioning

confidence: 99%

The efficacy and safety of Saccharomyces boulardii in addition to antofloxacin-based bismuth quadruple therapy for Helicobacter pylori eradication: a single-center, prospective randomized-control study

Wang

Sun

et al. 2023

Therap Adv Gastroenterol

Self Cite

View full text Add to dashboard Cite

show abstract

“…Table 2 summarizes the intention-to-treat and per-protocol eradication rates of various H. pylori eradication regimens including standard bismuth quadruple therapy (tetracycline-metronidazole quadruple therapy), fluoroquinolone-amoxicillin triple therapy, fluoroquinolone-amoxicillin quadruple therapy, tetracycline-fluoroquinolone quadruple therapy, high-dose dual therapy, levofloxacin-based sequential therapy, tetracycline-metronidazole-amoxicillin concomitant therapy, furazolidone-tetracycline quadruple therapy, furazolidone-amoxicillin quadruple therapy, amoxicillin-clarithromycin-metronidazole tetracycline quintuple therapy, and tetracycline-metronidazole-ofloxacin quintuple therapy. 14 , 19 , 21 – 33 …”

Section: Second-line Therapies For H Pylori Infectionmentioning

confidence: 99%

Update on the second-line treatment of Helicobacter pylori infection: a narrative review

Shih,

Shie,

Tai

et al. 2023

Therap Adv Gastroenterol

View full text Add to dashboard Cite

A standard bismuth quadruple therapy, a fluoroquinolone-containing triple (or quadruple) therapy or a proton pump inhibitor (PPI)-amoxicillin high-dose dual therapy has been recommended as a second-line treatment for Helicobacter pylori infection by the Maastricht VI/Florence Consensus Report. The major shortcoming of levofloxacin-amoxicillin triple therapy is low cure rate for eradicating levofloxacin-resistant strains. With the rising prevalence of levofloxacin-resistant strains, levofloxacin-amoxicillin triple therapy cannot reliably achieve a high eradication rate for second-line treatment of H. pylori infection in most countries now. The present article aims to review current second-line eradication regimens with a per-protocol eradication rate exceeding 85% in most geographic areas. Recently, a novel tetracycline-levofloxacin quadruple therapy consisting of a PPI, bismuth, tetracycline, and levofloxacin for rescue treatment of H. pylori infection has been developed. The new therapy achieved a higher per-protocol eradication rate than levofloxacin-amoxicillin triple treatment in a randomized controlled trial (98% versus 69%). Additionally, the tetracycline-levofloxacin quadruple therapy also exhibits a higher eradication rate than amoxicillin-levofloxacin quadruple therapy. High-dose dual PPI-amoxicillin therapy is another novel second-line treatment for H. pylori infection. The new therapy can achieve an eradication rate of 89% by per-protocol analysis for the second-line treatment in Taiwan. Recently, levofloxacin-based sequential quadruple therapy and potassium-competitive acid blocker have also been applied in the second-line treatment of H. pylori infection. A meta-analysis revealed that a vonoprazan-based regimen has significant superiority over a PPI-based regimen for second-line H. pylori eradication therapy. In conclusion, the eradication rate of levofloxacin-amoxicillin triple therapy is suboptimal in the second-line treatment of H. pylori infection now. Currently, a standard bismuth quadruple therapy (tetracycline-metronidazole quadruple therapy), a tetracycline-levofloxacin quadruple therapy, an amoxicillin-levofloxacin quadruple therapy, a levofloxacin-based sequential quadruple therapy or a high-dose PPI-amoxicillin dual therapy is recommended for the second-line treatment of H. pylori infection.

show abstract

“…The eradication rate of the levofloxacin group was higher than that of the antofloxacin group (87.6 vs. 68.5%) when the levofloxacin resistance rate was over 40%. Antofloxacin has both good efficacy and safety ( Mori et al, 2020 ; He et al, 2022 ). Second, previous reports have demonstrated that furazolidone has a good eradication effect in first-line treatment.…”

Section: Options For Rescue Treatment: Antibiotic-susceptibility Test...mentioning

confidence: 99%

Treatment of refractory Helicobacter pylori infection: A new challenge for clinicians

He²,

Zhu³

2022

Front. Microbiol.

View full text Add to dashboard Cite

Patients who have failed two or more attempts to eradicate Helicobacter pylori are commonly referred to as refractory. Although the incidence of refractory Helicobacter pylori infection is only 10–20%, with the increasing rate of antibiotic resistance in various regions, the treatment of refractory Helicobacter pylori infection has gradually become a difficult problem faced by clinicians. When choosing a rescue therapy, the physician must consider numerous factors. A longer treatment duration, higher doses of proton pump inhibitors (PPIs), or the use of potassium-competitive acid blocker (P-CAB) may increase the efficacy of triple therapy or bismuth quadruple therapy. Rescue treatment based on bismuth quadruple therapy usually achieves better results. At the same time, treatment based on drug susceptibility tests or genotypic resistance is recommended where available. Of course, appropriate empiric treatment can also be selected according to local drug resistance, a patient’s previous medication history and compliance. It is the best choice if it can improve the success rate of the first treatment and reduce the occurrence of refractory Helicobacter pylori infection. This review aims to summarize the articles related to refractory Helicobacter pylori in recent years and to explore a better remedial treatment plan for clinicians.

show abstract

Efficacy and Safety of Antofloxacin-Based Triple Therapy for Helicobacter pylori Eradication Failure in China

Cited by 4 publications

References 32 publications

The efficacy and safety of Saccharomyces boulardii in addition to antofloxacin-based bismuth quadruple therapy for Helicobacter pylori eradication: a single-center, prospective randomized-control study

The efficacy and safety of Saccharomyces boulardii in addition to antofloxacin-based bismuth quadruple therapy for Helicobacter pylori eradication: a single-center, prospective randomized-control study

Update on the second-line treatment of Helicobacter pylori infection: a narrative review

Treatment of refractory Helicobacter pylori infection: A new challenge for clinicians

Contact Info

Product

Resources

About