High efficacy of 1‐week doxycycline‐ and amoxicillin‐based quadruple regimen in a culture‐guided, third‐line treatment approach for <scp>Helicobacter pylori</scp> infection

Cammarota, Giovanni; Martino, Antonio; Pirozzi, Giuseppe; Cianci, Rossella; Branca, G.; Nista, E.C.; Cazzato, Alessia; Cannizzaro, O; Miele, Luca; Grieco, Antonio; Gasbarrini, Antonio; Gasbarrini, Giovanni

doi:10.1111/j.1365-2036.2004.01910.x

Cited by 98 publications

(97 citation statements)

References 37 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…H owe ve r, l i m i t e d e x p e r i e n c e s u g g e s t s t h a t endoscopy with culture and susceptibility testing may be appropriate after failure of two eradication therapies; in this situation, a non-randomized retrospective study suggests that third-line therapy directed by the results of sensitivity testing improve eradication compared to further empirical antibiotics, demonstrating that the success rate of sensitivity-directed therapy is superior to PPI-amoxicillin-rifabutin triple therapy, and therefore suggesting that endoscopy and sensitivity testing at this point may be worthwhile rather than more widespread use of rifabutin-based regimens [72] . Cammarota et al [122] assessed the efficacy of a third-line, culture-guided treatment approach for the eradication of H pylori. After the first two eradication attempts, all patients were resistant to metronidazole, and 95% were resistant to clarithromycin.…”

Section: Is It Necessary To Performmentioning

confidence: 99%

“…Moreover, two metaanalyses have demonstrated a lower incidence of adverse effects with levofloxacin-based treatments than with the quadruple combinations [88,89] . Unfortunately, it has been shown that resistance to quinolones is easily acquired, and in countries with a high consumption of these drugs, the resistance rate is increasing and is already relatively high [94,103,107,[113][114][115][116][117][118][119][120][121][122][123] . More importantly, it has been demonstrated that the presence of levofloxacin resistance significantly reduce the eradication rate following a therapy with this antibiotic [94,103,121,124] .…”

Section: Rbc Tetracycline and Metronidazolementioning

confidence: 99%

See 1 more Smart Citation

“Rescue” regimens after Helicobacter pylori treatment failure

Gisbert¹

2008

WJG

View full text Add to dashboard Cite

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.

show abstract

Section: Is It Necessary To Performmentioning

confidence: 99%

Section: Rbc Tetracycline and Metronidazolementioning

confidence: 99%

“Rescue” regimens after Helicobacter pylori treatment failure

Gisbert¹

2008

WJG

View full text Add to dashboard Cite

show abstract

“…30 These differences probably reflect the uses of this compound in other clinical setting, which can vary between countries or regions. This levofloxacin base treatment was able to eradicate most of the strains resistant to both clarithromycin and metronidazole (92.3%; 95% CI: 83.2-86.7).…”

mentioning

confidence: 99%

A 10‐day levofloxacin‐based triple therapy in patients who have failed two eradication courses

Gatta

Zullo

Perna

et al. 2005

Aliment Pharmacol Ther

109

View full text Add to dashboard Cite

Background: A standard third-line treatment is lacking, and European guidelines recommend performing culture in these patients. However, the use of this procedure as 'routine practice' is definitively not feasible. Aim: To evaluate the eradication rate of a 10-day levofloxacin-based triple therapy in patients who have failed two eradication courses for Helicobacter pylori. Methods: A total of 151 patients with persistent Helicobacter pylori infection after two treatments were studied. Patients were considered positive if two of three endoscopic tests were positive. Susceptibility testing was also performed. Patients received a standard dose of

show abstract

“…A culture-guided rescue quadruple therapy using omeprazole, bismuth, doxycycline and amoxicillin for 1 week demonstrated eradication rates of 91% (ITT) and 92% (PP) despite high drug resistances (metronidazole, 100%; clarithromycin, 95%; levofloxacin, 31%; and tetracycline, 5%). Therefore, this amoxicillin and doxycycline-based quadruple regimen can be a good third line rescue treatment option [74]. Another rescue trial with furazolidone based quadruple therapy (rebeprazole, 20 mg; amoxicillin, 1 gm; bismuth subcitrate, 220 mg; furazolidone, 100 mg bid*14 days or furazolidone, 100 mg tid *7 days) had eradications rates of 89%/85% according to ITT/PP analysis at 14 days and 90% at 7 days [75].…”

Section: Rescue Therapymentioning

confidence: 99%

Helicobacter pylori infection: A recent approach to diagnosis and management

Rana¹,

Wang²,

Li³

et al. 2017

J. Biomed

View full text Add to dashboard Cite

Helicobacter pylori infection is the most common infection worldwide and is associated with simple dyspepsia, heartburn and peptic ulcer diseases, most commonly leading to upper gastrointestinal bleeding and, ultimately, to the severe complication of gastric malignancy. Ninety percent of duodenal ulcers and 70% of gastric ulcers are associated with helicobacter pylori infections. Noninvasive methods, such as the urea breath test (UBT-13C or 14C) and fecal antigen test (FAT), have high sensitivity and specificity for the diagnosis of H. pylori. However, 4-6 weeks of anti-secretary drugs (proton pump inhibitor) prior to testing can lead to false negative results. Invasive methods have benefits over noninvasive methods in the case of peptic ulcer diseases by taking samples for culture to determine their sensitivities and to stage disease progression to malignant transformation. Initially, standard triple regimen was the choice for treatment worldwide. However, high antibiotic resistances in various geographical regions have recently made standard quadruple therapy (bismuth-based) the preferred treatment. Recent studies have shown the promising benefits of 10-14 days of sequential and concomitant quadruple therapies as the first line option in high drug resistance areas, in cases of multidrug resistance or in prior treatment failure cases. Levofloxacin-based triple therapy, furazolidone-based regimens, and recent hybrid or rescue therapies are also beneficial towards the eradication of H. pylori infection as a second or third line therapy. Additionally, the use of probiotics and phytomedicines improve eradication rates when used with triple or quadruple therapies.

show abstract

High efficacy of 1‐week doxycycline‐ and amoxicillin‐based quadruple regimen in a culture‐guided, third‐line treatment approach for Helicobacter pylori infection

Cited by 98 publications

References 37 publications

“Rescue” regimens after Helicobacter pylori treatment failure

“Rescue” regimens after Helicobacter pylori treatment failure

A 10‐day levofloxacin‐based triple therapy in patients who have failed two eradication courses

Helicobacter pylori infection: A recent approach to diagnosis and management

Contact Info

Product

Resources

About