Comparison of 10-day levofloxacin bismuth-based quadruple therapy and levofloxacin-based triple therapy for Helicobacter pylori

Autor:	Deng-Chyang Wu, Fu-Chen Kuo, Yen-Hsu Chen, Tzung-Shiun Wu, Ping-I Hsu, Chao-Hung Kuo, I-Chen Wu, Huang-Ming Hu, Wei-Wen Su, Sophie S.W. Wang
Rok vydání:	2017
Předmět:	medicine.medical_specialty biology business.industry medicine.drug_class Antibiotics Gastroenterology Rabeprazole Helicobacter pylori Amoxicillin bacterial infections and mycoses biology.organism_classification Surgery 03 medical and health sciences 0302 clinical medicine Bismuth Subcitrate Levofloxacin 030220 oncology & carcinogenesis Internal medicine medicine 030211 gastroenterology & hepatology business Adverse effect Prospective cohort study medicine.drug
Zdroj:	Journal of Digestive Diseases. 18:537-542
ISSN:	1751-2972
DOI:	10.1111/1751-2980.12498
Popis:	OBJECTIVE This was a prospective study aiming to investigate whether levofloxacin plus bismuth-based quadruple therapy was more effective than levofloxacin-based triple therapy after failed first-line eradication therapies for Helicobacter pylori (H. pylori) infection. METHODS Sixty-seven patients infected with H. pylori were randomly assigned to two groups; the levofloxacin plus bismuth-based quadruple therapy group (RBAL [n = 33]; rabeprazole 20 mg twice daily, bismuth subcitrate 120 mg four times daily, amoxicillin 1 g twice daily and levofloxacin 500 mg once daily, for 10 days) and the levofloxacin-based triple therapy group (RAL [n = 34]; rabeprazole 20 mg twice daily, amoxicillin 1 g twice daily and levofloxacin 500 mg once daily, for 10 days). Endoscopy was performed 4–8 weeks after H. pylori eradication to assess treatment response. We followed up patient response and compliance and checked their resistance to antibiotics. RESULTS Intention-to-treat analysis revealed that both groups had similar eradication rates (RBAL vs RAL: 84.8% [95% confidence interval {CI} 72.6–97.1%] vs 67.6% [95% CI 51.9–83.4%], P = 0.0987). No significant differences in compliance or adverse events were found (P = 0.9829 and 0.0720). Epsilometer test showed that most eradication failure cases were levofloxacin-resistant. CONCLUSIONS Adding bismuth subcitrate to levofloxacin-based triple therapy was not more effective than not doing so, but no further side effects were noted. Both eradication therapies were equally safe and patients had the same tolerance to both regimens. Resistance rate to levofloxacin may be important when choosing second-line therapy.
Databáze:	OpenAIRE
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