Levofloxacin‐ vs. Ranitidine Bismuth Citrate‐Containing Therapy After <i>H. pylori</i> Treatment Failure

Gisbert, Javier P.; Gisbert, José Luis; Marcos, Santiago; Moreno–Otero, Ricardo; Jm, Pajares García

doi:10.1111/j.1523-5378.2007.00472.x

Cited by 24 publications

(18 citation statements)

References 27 publications

(56 reference statements)

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“…Los anteriores resultados son similares a los descritos por Kuo et al 13 , Molina-Infante et al 79 y Cheng et al 80 . Como terapia de rescate de segunda línea, las tasas de erradicación oscilaron desde aceptables a excelentes en terapias de 10 días 28,56,59,60 , mientras que fueron desde pobres a inaceptables en 7 días 40,54 . La tasa con menor éxito de erradicación se obtuvo en un ensayo clínico realizado en Turquía, lo cual podría estar relacionado con el hecho que esta terapia podría presentar fallas de éxito en poblaciones asiáticas y europeas con resistencia alta a fluoroquinolonas, disminuyendo su eficacia incluso a tasas aproximadas del 33% 81,82 .…”

Section: Discussionunclassified

“…Adicionalmente, en Taiwán la terapia cuádruple estándar con bismuto (IBP, bismuto, tetraciclina y metronidazol) versus la terapia cuádruple (IBP, bismuto, tetraciclina, amoxicilina) de 7 días de duración logró tasas de erradicación en análisis por ITT del 81 y del 62% en cada grupo 39 . Finalmente, en población española, la terapia triple con ranitidina citrato bismuto (RCB), tetraciclina y metronidazol versus la triple terapia con levofloxacina fueron eficaces en el 69 y el 71%, respectivamente, sin diferencias estadísticamente significativas 40 .…”

Section: Ensayos Clínicos Aleatorizadosunclassified

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Tratamiento ideal del Helicobacter pylori: una revisión sistemática

Sierra

Forero

Rey

2014

Revista de Gastroenterología de México

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Section: Discussionunclassified

Section: Ensayos Clínicos Aleatorizadosunclassified

Tratamiento ideal del Helicobacter pylori: una revisión sistemática

Sierra

Forero

Rey

2014

Revista de Gastroenterología de México

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“…30,56 The above results are similar to those described by Kuo et al, 13 Molina-Infante et al, 79 and Cheng et al 80 As second-line rescue therapy, the eradication rates varied from acceptable to excellent with 10-day therapies, 28,56,59,60 whereas they ranged from poor to unacceptable with 7-day treatments. 40,54 The least successful eradication rate was obtained in a clinical trial conducted in Turkey, and might be related to the fact that this therapy could present success failures in Asian and European populations with a high resistance to fluoroquinolones, reducing their effectiveness to rates of approximately 33%. 81,82 The abovementioned studies suggest that the triple therapy with a dose of 400 mg/day of levofloxacin is less effective compared with a therapy using 800 mg per day, whereas better results could be obtained with more prolonged therapies.…”

Section: Discussionmentioning

confidence: 99%

“…39 And finally, in the Spanish population, the triple therapy with ranitidine bismuth citrate (RBC), tetracycline, and metronidazole versus the triple therapy with levofloxacin were effective in 69 and 71%, respectively, with no statistically significant differences. 40 Of the Latin American randomized clinical experiments included in the study, the following eradication rates for the clarithromycinbased standard triple therapy as first-line treatment were obtained: in Colombia, the effectiveness of 7-day versus 14-day treatment reached ITT eradication rates of 67.8 and 74.3%, respectively; 41 in Chile, 7-day versus 14-day treatment had rates of 78.3 and 85.5%; 42 in Ecuador, 7-day versus 10-day treatment, 68.3 and 83.8%; 43 and in Brazil, the standard triple therapy with clarithromycin versus a control group (PPI plus placebo), both of 10-day duration, had rates of 88.6 and 7.4%, respectively. 44 As second-line therapy, in Colombia, the 14-day clarithromycin-based triple therapy with lansoprazole versus omeprazole reached eradication rates of 69 and 70% in each respective regimen, with no statistically significant difference.…”

Section: Randomized Clinical Trialsmentioning

confidence: 99%

Ideal treatment for Helicobacter pylori: A systematic review

Sierra

Forero

Rey

2014

Revista de Gastroenterología de México (English Edition)

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Background: The success rates of therapies for treating Helicobacter pylori vary greatly worldwide and the ideal treatment has yet to be clearly established. Aims: A systematic review was carried out to evaluate the effectiveness of current first and second-line therapies in treating H. pylori infection. Methods: Two researchers independently carried out Internet search engine reviews (PUBMED, EMBASE, MEDLINE) of clinical trials on adults published between 1990 and 2012 in both English and Spanish. Results: Forty-three (n = 8,123) clinical trials were evaluated that included first and second-line triple, quadruple, and sequential therapies. The eradication rates of the standard triple therapy are unacceptable (≤ 80%) in countries where H. pylori is highly resistant to clarithromycin and metronidazole. Administration of the standard triple therapy for more than 7 days does not improve its effectiveness. No statistically significant differences were observed between the eradication rates of the quadruple therapy with bismuth and the standard triple therapy. Even though the sequential and concomitant therapies are equally successful regimens, the triple therapy with levofloxacin offers the best results as first and second-line treatment, but quinolone resistance can diminish its effectiveness. The triple therapy with levofloxacin and the sequential and concomitant treatments were superior to the standard triple regimen as first-line therapy. Conclusions: Currently there is no ideal first or second-line treatment for achieving 100% eradication. The therapeutic order should be carried out according to the initial treatment and local antimicrobial resistance studies. Tratamiento ideal del Helicobacter pylori: una revisión sistemática ResumenAntecedentes: Las tasas de éxito de las terapias para tratar el Helicobacter pylori varían ampliamente a nivel mundial. El tratamiento óptimo no ha sido claramente establecido. Objetivo: Se realizó un revisión sistemática para evaluar la eficacia de las terapias actuales de primera y segunda línea en la infección por Helicobacter pylori. Métodos: Dos investigadores realizaron la revisión independiente en motores de búsqueda electrónica (PUBMED, EMBASE, MEDLINE) de ensayos clínicos publicados entre 1990 y 2012, incluyendo adultos e idiomas inglés y español. Resultados: Se evaluaron 43 ensayos clínicos (n = 8,123), que incluyen terapias triples, cuádruples y secuenciales, de primera y segunda línea. Las tasas de erradicación de la terapia triple estándar son inaceptables (≤ 80%) en países donde el H. pylori presenta alta resistencia a claritromicina y metronidazol. Un tiempo mayor a 7 días no mejora la eficacia de la triple terapia estándar. No se observaron diferencias significativas entre las tasas de erradicación de la terapia cuádruple con bismuto y la triple terapia estándar. Aunque las terapias secuencial y concomitante son regímenes igualmente exitosos, la terapia triple con levofloxacino ofrece los mejores resultados como primera y segunda línea, pero la resistencia a quinolon...

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“…Surprisingly, the authors stated that adverse effects were infrequent and mild with both regimens [Gisbert et al 1999]. A second controlled study comparing ranitidine bismuth citrate, tetracycline and metronidazole with a PPI-based triple therapy containing omeprazole, levofloxacin and amoxicillin showed similar results in both groups for cure rates, side-effects and adherence [Gisbert et al 2007]. Ranitidine bismuth citrate, amoxicillin and tinidazole resulted in comparable eradication rates to a quadruple-therapy regimen [Perri et al 2003].…”

Section: Pharmacodynamic Effectsmentioning

confidence: 99%

Review: Eradication of H. pylori infection: the challenge is on if standard therapy fails

Bohr

Malfertheiner

2009

Therap Adv Gastroenterol

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The recommended standard triple therapy for Helicobacter pylori infection, consisting of a proton pump inhibitor, clarithromycin and amoxicillin or metronidazole, can reach eradication rates in over 90%. However, in recent years resistance to antibiotics has increased and eradication rates have declined. Approximately one in five patients need a second-line therapy because eradication therapy fails. Second-line treatment with a bismuth-based quadruple therapy leads to satisfactory eradication rates, but bismuth is not available in many countries. Modern second-and third-line treatments can only be successful if they are adapted to the current resistance situation and they need to evolve continuously. Moreover, pharmacodynamic effects due to polymorphisms of the cytochrome P450 system are important. Because therapy adherence is significantly associated with therapy success, modern regimens if possible should be easy to take and well tolerated. In recent years, various novel salvage-therapy regimens have been investigated that significantly improve treatment options.

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Levofloxacin‐ vs. Ranitidine Bismuth Citrate‐Containing Therapy After H. pylori Treatment Failure

Abstract: Both 7-day ranitidine bismuth citrate- and levofloxacin-containing second-line regimens represent alternatives to quadruple therapy in patients with previous omeprazole-clarithromycin-amoxicillin failure.

Cited by 24 publications

References 27 publications

Tratamiento ideal del Helicobacter pylori: una revisión sistemática

Tratamiento ideal del Helicobacter pylori: una revisión sistemática

Ideal treatment for Helicobacter pylori: A systematic review

Review: Eradication of H. pylori infection: the challenge is on if standard therapy fails

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