Lansoprazole, levofloxacin and amoxicillin triple therapy vs. quadruple therapy as second-line treatment of resistant Helicobacter pylori infection.

Autor: WONG, W. M., GU, Q., CHU, K.‐M., YEE, Y. K., FUNG, F. M. Y., TONG, T. S. M., CHAN, A. O. O., LAI, K. C., CHAN, C. K., WONG, B. C. Y.
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Zdroj: Alimentary Pharmacology & Therapeutics; Feb2006, Vol. 23 Issue 3, p421-427, 7p, 3 Charts
Abstrakt: Aim To test the efficacy of levofloxacin-based second-line therapy for resistant Helicobacter pylori infection. Methods One hundred and six patients who failed H. pylori eradication were randomized to receive (i) lansoprazole 30 mg, amoxicillin 1 g, levofloxacin 500 mg, all given twice daily for 7 days (LAL); or (ii) lansoprazole 30 mg twice daily, metronidazole 400 mg thrice daily, bismuth subcitrate 120 mg and tetracycline 500 mg four times daily for 7 days (quadruple). Post-treatment H. pylori status was determined by 13C-urea breath test. Results Intention-to-treat and per-protocol H. pylori eradication rates were 57/60% for the LAL group and 71/76% for the quadruple group respectively. Metronidazole, clarithromycin, amoxicillin and levofloxacin resistance were found in 76%, 71%, 0% and 18% of patients, respectively. Levofloxacin resistance led to treatment failure in the LAL group. For patients with dual resistance to metronidazole and clarithromycin, the eradication rates were 79% in the LAL group (levofloxacin-sensitive) and 65% in the quadruple group ( P = 0.34). Conclusion Lansoprazole, amoxicillin plus levofloxacin second-line therapy is comparable with quadruple therapy in efficacy. Subjects, especially those with dual resistance to metronidazole and clarithromycin, may consider levofloxacin-based therapy for levofloxacin-sensitive strains. [ABSTRACT FROM AUTHOR]
Databáze: Complementary Index
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