Document Detail


Levofloxacin-based triple therapy for Helicobacter pylori re-treatment: role of bacterial resistance.
MedLine Citation:
PMID:  17889627     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: First-line Helicobacter pylori therapy fails in more than 20% of patients. Quadruple therapy is the suggested second-line therapy, but bismuth salts are not anymore available worldwide. This study aimed to assess the efficacy of a levofloxacin-amoxycillin triple therapy as a second-line treatment, and the role of primary levofloxacin resistance.
METHODS: Forty patients, in whom first treatment with either standard 10-day triple or sequential therapy had failed, received 10-day triple therapy with rabeprazole (20mg b.d.), levofloxacin (250mg b.d.), and amoxycillin (1g b.d.). Cure rates were evaluated by the (13)C-urea breath test. Primary levofloxacin resistance was detected by culture.
RESULTS: Bacterial culture was available in 33 (82.5%) out 40 patients, and primary levofloxacin resistance was detected in 10 (30.3%) patients. Overall, 33 of 40 patients accepted to participate in this study, and all returned for follow-up after therapy. Compliance to the therapy was safe except 1 patient only who stopped earlier the treatment due to side effects (oral candidiasis). H. pylori infection was eradicated in 24 patients, accounting for a 72.7% (95% CI: 57-88) eradication rate at both intention-to-treat and per protocol analyses. The eradication rate was higher in patients harbouring levofloxacin-susceptible than resistant strains (75% versus 33.3%; P=0.074).
CONCLUSIONS: The eradication rate achieved by a levofloxacin-based re-treatment seems to be decreasing, and its efficacy is reduced in presence of levofloxacin resistance.
Authors:
F Perna; A Zullo; C Ricci; C Hassan; S Morini; D Vaira
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Publication Detail:
Type:  Clinical Trial; Journal Article; Multicenter Study     Date:  2007-09-21
Journal Detail:
Title:  Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver     Volume:  39     ISSN:  1590-8658     ISO Abbreviation:  Dig Liver Dis     Publication Date:  2007 Nov 
Date Detail:
Created Date:  2007-11-06     Completed Date:  2008-02-12     Revised Date:  2013-04-16    
Medline Journal Info:
Nlm Unique ID:  100958385     Medline TA:  Dig Liver Dis     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  1001-5     Citation Subset:  IM    
Affiliation:
Department of Internal Medicine and Gastroenterology, University of Bologna, Bologna, Italy.
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MeSH Terms
Descriptor/Qualifier:
2-Pyridinylmethylsulfinylbenzimidazoles / therapeutic use
Adult
Amoxicillin / therapeutic use
Anti-Bacterial Agents / therapeutic use*
Breath Tests
Drug Resistance, Bacterial*
Drug Therapy, Combination
Female
Helicobacter Infections / drug therapy*
Humans
Male
Middle Aged
Ofloxacin / therapeutic use*
Prospective Studies
Proton Pump Inhibitors / therapeutic use
Retreatment
Chemical
Reg. No./Substance:
0/2-Pyridinylmethylsulfinylbenzimidazoles; 0/Anti-Bacterial Agents; 0/Proton Pump Inhibitors; 26787-78-0/Amoxicillin; 32828355LL/rabeprazole; 82419-36-1/Ofloxacin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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