First‐line triple therapy with levofloxacin for <i>Helicobacter pylori</i> eradication

Gisbert, Javier P.; Fernandez–Bermejo, Miguel; Molina–Infante, Javier; Perez-Gallardo, Belen; Prieto-Bermejo, Ana Beatriz; Mateos-Rodríguez, José María; Robledo-Andrés, Pilar; González-García, Guadalupe

doi:10.1111/j.1365-2036.2007.03384.x

Cited by 47 publications

(53 citation statements)

References 54 publications

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“…The present study showed an eradication rate of 79% and 69% with the STT and 87% and 80% with the LBT in PP and ITT analysis respectively. Gisbert et al [10] studied the efficacy of LBT as the first line treatment of H. pylori and found eradication rates of 88% and 84% under PP and ITT analysis respectively, which are comparable to the results of our study. Schrauwen et al [24] from the Netherlands found that therapy with the levofloxacin regimen was very effective in the eradication of H. pylori.…”

supporting

confidence: 82%

“…Vaira et al [20] reported a compliance rate of 94% in patients receiving STT. Gisbert et al [10] reported similar adherence to treatment in his study among patients receiving both STT and LBT.…”

mentioning

confidence: 49%

“…Limited studies have been reported comparing the eradication rates for H. pylori between standard triple therapy (STT) and LBT [10] . Hence, this study was done to compare the efficacy of STT to LBT as a first line therapy for the eradication of H. pylori and the prevention of ulcer recurrence in patients with perforated duodenal ulcer following simple closure.…”

Section: Introductionmentioning

confidence: 99%

“…This is attributed to the development of resistance to clarithromycin. Levofloxacin based therapy (LBT) has been recently reported to have higher and consistent eradication rates as a first line therapy in H. pylori eradication [10][11][12] . LBT represents a better alternative to clarithromycin therapy as it meets the criteria set for H. pylori treatment: effectiveness, simplicity and safety.…”

Section: Introductionmentioning

confidence: 99%

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Standard triple versus levofloxacin based regimen for eradication ofHelicobacter pylori

Gopal

Elamurugan²,

Kate³

et al. 2013

WJGPT

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AIM:To compare the eradication rates for Helicobacter pylori (H. pylori ) and ulcer recurrence of standard triple therapy (STT) and levofloxacin based therapy (LBT). METHODS:Seventy-four patients with perforated duodenal ulcer treated with simple closure and found to be H. pylori infected on 3 mo follow up were randomized to receive either the STT group comprising of amoxicillin 1 g bid , clarithromycin 500 mg bid and omeprazole 20 mg bid or the LBT group comprising of amoxicillin 1 g bid , levofloxacin 500 mg bid and omeprazole 20 mg bid for 10 d each. The H. pylori eradication rates, side effects, compliance and the recurrence of ulcer were assessed in the two groups at 3 mo follow up. RESULTS:Thirty-four patients in the STT group and 32 patients in the levofloxacin group presented at 3 mo fol-

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supporting

confidence: 82%

mentioning

confidence: 49%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Standard triple versus levofloxacin based regimen for eradication ofHelicobacter pylori

Gopal

Elamurugan²,

Kate³

et al. 2013

WJGPT

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“…These favorable results have been confirmed in vivo, indicating that most of the patients with both metronidazole and clarithromycin resistance are cured with the levofloxacin-based regimen [52,94,100] . A combination of a PPI, amoxicillin and levofloxacin, as a first-line regimen, has been associated with favorable results, with mean eradication rates of about 90% [95,[101][102][103][104][105][106] . Subsequently, other authors studied this same regimen in patients with one previous eradication failure, also reporting exciting results, with H pylori cure rates ranging from 60% to 94%…”

Section: Rbc Tetracycline and Metronidazolementioning

confidence: 99%

“Rescue” regimens after Helicobacter pylori treatment failure

Gisbert¹

2008

WJG

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Helicobacter pylori (H pylori ) infection is the main cause of gastritis, gastroduodenal ulcer disease, and gastric cancer. After more than 20 years of experience in H pylori treatment, in my opinion, the ideal regimen to treat this infection is still to be found. Currently, apart from having to know first-line eradication regimens well, we must also be prepared to face treatment failures. Therefore, in designing a treatment strategy we should not focus on the results of primary therapy alone, but also on the final (overall) eradication rate. The choice of a "rescue" treatment depends on which treatment is used initially. If a clarithromycinbased regimen was used initially, a subsequent metronidazole-based treatment (quadruple therapy) may be used afterwards, and then a levofloxacinbased combination would be a third "rescue" option. Alternatively, it has recently been suggested that levofloxacin-based rescue therapy constitutes an encouraging second-line strategy, representing an alternative to quadruple therapy in patients with previous PPI-clarithromycin-amoxicillin failure, with the advantage of efficacy, simplicity and safety. In this case, a quadruple regimen may be reserved as a third-line rescue option. Finally, rifabutin-based rescue therapy constitutes an encouraging empirical fourthline strategy after multiple previous eradication failures with key antibiotics such as amoxicillin, clarithromycin, metronidazole, tetracycline, and levofloxacin. Even after two consecutive failures, several studies have demonstrated that H pylori eradication can finally be achieved in almost all patients if several rescue therapies are consecutively given. Therefore, the attitude in H pylori eradication therapy failure, even after two or more unsuccessful attempts, should be to fight and not to surrender.

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