Standard triple versus levofloxacin based regimen for eradication of<i>Helicobacter pylori</i>

Gopal, Raj; Elamurugan, T P; Kate, Vikram; Jagdish, S; Basu, Debdatta

doi:10.4292/wjgpt.v4.i2.23

Cited by 10 publications

(6 citation statements)

References 23 publications

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“…Comparable results have been reported in study by Gopal et al and another study by Cheng H et al who compared the standard clarithromycin triple therapy to levofloxacin-contained triple therapy with eradication rates lower than our results [34,35].…”

Section: Discussionsupporting

confidence: 89%

Helicobacter Pylori Treatment Eradication in Egypt: Standard Clarithromycin-based Triple versus Quadruple Regimen Therapy

Afifi

Elantouny

El-Sokkary

et al. 2020

Afro-Egyptian Journal of Infectious and Endemic Diseases

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Background and study aim: Absence of adequate treatment for Helicobacter pylori (H. pylori) infection leads to prolonged life time colonization which is responsible for complications. Antibiotics resistance is the main cause of eradication failure in H. pylori infection, thus our study aimed to evaluate the efficiency and tolerability of standard triple therapy vs. quadruple regimen therapy in H. pylori eradication in Egypt. Subjects andMethods: Our study enrolled 140 patients (65 males,75 females) who attending to Gastroenterology clinic in Internal medicine & Tropical medicine departments, Zagazig University Hospitals from (June 2018 -June 2019), aged from 20 -60 years, complained of recurrent non-specific dyspepsia and epigastric pain & proved to be positive for H. pylori stool antigen test. The patients distributed into two groups: group (1), 70 patients given Clarithromycin triple therapy [Clarithromycin 500 mg + Amoxicillin 1gm + Pantoprazole 40 mg, each twice daily]. Group (2), 70 patients given quadruple therapy [Levofloxacin 500 mg once daily + Nitazoxanide 500mg (twice daily)+ Doxycycline 100 mg (twice daily)+ Pantoprazole 40 mg (twice daily)] for 14 days. Results: H. pylori eradication rate was statistically significant higher in patients who received quadruple therapy compared to those who received Clarithromycin-based triple therapy ( 85.7% vs. 67.1 % & P = 0.001 respectively).While, statistically insignificant regarding the treatment side effects in both groups ( 11.4 % vs. 14.3 %, P= 0.33 respectively). Conclusion: Quadruple therapy is preferable to Clarithromycin-contained triple therapy in tolerability and eradication of H. pylori in Egypt.

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Section: Discussionsupporting

confidence: 89%

Helicobacter Pylori Treatment Eradication in Egypt: Standard Clarithromycin-based Triple versus Quadruple Regimen Therapy

Afifi

Elantouny

El-Sokkary

et al. 2020

Afro-Egyptian Journal of Infectious and Endemic Diseases

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“…Earlier reports from this institute showed a prevalence of H. pylori infection in perforated duodenal ulcer ranging from 56% to 65%. [ 5 15 16 ] H. pylori prevalance in the present study was 64.76%. In the present study, ST achieved an eradication of 71.43%, 78.13%, and 86.20% by ITT, mITT, and PP analyses, respectively.…”

Section: Discussionsupporting

confidence: 42%

Sequential versus concomitant therapy for eradication of Helicobacter Pylori in patients with perforated duodenal ulcer: A randomized trial

Das

Sureshkumar

Sreenath

et al. 2016

Saudi J Gastroenterol

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Objectives:Comparison of Helicobacter pylori eradication rates, side effects, compliance, cost, and ulcer recurrence of sequential therapy (ST) with that of concomitant therapy (CT) in patients with perforated duodenal ulcer following simple omental patch closure.Methods:Sixty-eight patients with perforated duodenal ulcer treated with simple closure and found to be H. pylori positive on three months follow-up were randomized to receive either ST or CT for H. pylori eradication. Urease test and Giemsa stain were used to assess for H. pylori eradication status. Follow-up endoscopies were done after 3 months, 6 months, and 1 year to evaluate the ulcer recurrence.Results:H. pylori eradication rates were similar in ST and CT groups on intention-to-treat (ITT) analysis (71.43% vs 81.80%,P = 0.40). Similar eradication rates were also found in per-protocol (PP) analysis (86.20% vs 90%,P = 0.71). Ulcer recurrence rate in ST groups and CT groups at 3 months (17.14% vs 6.06%,P = 0.26), 6 months (22.86% vs 9.09%,P = 0.19), and at 1 year (25.71% vs 15.15%,P = 0.37) of follow-up was also similar by ITT analysis. Compliance and side effects to therapies were comparable between the groups. The most common side effects were diarrhoea and metallic taste in ST and CT groups, respectively. A complete course of ST costs Indian Rupees (INR) 570.00, whereas CT costs INR 1080.00.Conclusion:H. pylori eradication rates, side effects, compliance, cost, and ulcer recurrences were similar between the two groups. The ST was more economical compared with CT.

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“…Recent meta-analysis from 104 studies in South Korea comprising 42,124 patients found the overall cure rate for triple therapy was 74.6% (95% CI 72.1%–77.2%) by intention-to-treat (ITT) and 82.0% (95% CI, 80.8%–83.2%) by per-protocol (PP), and the cure rate was decreased significantly from 1998 to 2013 [ 69 ]. Several studies in West and South Asia also showed the ineffectiveness of triple therapy as a first line treatment [ 32 , 70 ]. Moreover, substitution with MNZ in Vietnam still showed similar results with a cure rate <70% [ 71 ].…”

Section: The Various Established Eradication Regimens In Asiamentioning

confidence: 99%

Appropriate First-Line Regimens to Combat Helicobacter pylori Antibiotic Resistance: An Asian Perspective

Miftahussurur

Yamaoka

2015

Molecules

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Asia has the largest population of any continent and the highest incidence of gastric cancer in the world, making it very important in the context of Helicobacter pylori infection. According to current guidelines, standard triple therapy containing a proton pump inhibitor (PPI) and two antibiotics; amoxicillin (AMX) and clarithromycin (CAM) or metronidazole (MNZ), is still the preferred first-line regimen for treatment of H. pylori infection. However, the efficacy of legacy triple regimens has been seriously challenged, and they are gradually becoming ineffective. Moreover, some regions in Asia show patterns of emerging antimicrobial resistance. More effective regimens including the bismuth and non-bismuth quadruple, sequential, and dual-concomitant (hybrid) regimens are now replacing standard triple therapies as empirical first-line treatments on the basis of the understanding of the local prevalence of H. pylori antimicrobial resistance. Selection of PPI metabolized by the non-enzymatic pathway or minimal first pass metabolism and/or increasing dose of PPI are important to increase H. pylori eradication rates. Therefore, local antibiotic resistance surveillance updates, selection of appropriate first-line regimens with non-enzymatic PPI and/or increased doses of PPI, and detailed evaluation of patients’ prior antibiotic usage are all essential information to combat H. pylori antibiotic resistance in Asia.

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Standard triple versus levofloxacin based regimen for eradication ofHelicobacter pylori

Cited by 10 publications

References 23 publications

Helicobacter Pylori Treatment Eradication in Egypt: Standard Clarithromycin-based Triple versus Quadruple Regimen Therapy

Helicobacter Pylori Treatment Eradication in Egypt: Standard Clarithromycin-based Triple versus Quadruple Regimen Therapy

Sequential versus concomitant therapy for eradication of Helicobacter Pylori in patients with perforated duodenal ulcer: A randomized trial

Appropriate First-Line Regimens to Combat Helicobacter pylori Antibiotic Resistance: An Asian Perspective

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