7‐Day Triple Therapy of <i>Helicobacter pylori</i> Infection with Levofloxacin, Amoxicillin, and High‐Dose Esomeprazole in Patients with Known Antimicrobial Sensitivity

Antoš, David; Schneider-Brachert, Wulf; Bästlein, Elke; Hänel, Christine; Haferland, Christian; Büchner, M; Meier, Eberhard; Trump, Friedrich; Stolte, Manfred; Lehn, Norbert; Bayerdörffer, Ekkehard

doi:10.1111/j.0083-8703.2006.00375.x

Cited by 74 publications

(78 citation statements)

References 48 publications

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“…Furthermore, it was argued that in terms of the eradication rates, there were no differences between the treatment periods, PPI types and treatment indications. Levofloxacin is an antibiotic of the fluoroquinolones group that is demonstrated to be considerably effective against H. pylori in in vitro studies; primary resistance against levofloxacin is not observed very frequently and it has a synergic effect together with PPI (10,26,27). However, in the regions where these medicines are prevalently used, quinolone resistance develops easily, and today, quinolone resistance is reported to be relatively high.…”

Section: Discussionmentioning

confidence: 99%

“…In the recent studies performed on the treatment regimens containing levofloxacin, it has been demonstrated that levofloxacin is effective in the first-and second-line treatments, and with an efficacy rate over 80%, it can be included in the standard triple therapy instead of clarithromycin in the first-line eradication therapy of H. pylori (9)(10)(11)29,30). It has also been suggested that 7 days levofloxacin (500 mg b.i.d.…”

Section: Discussionmentioning

confidence: 99%

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Assessment of Helicobacter pylori eradication rate of triple combination therapy containing levofloxacin

Seven¹,

Çınar²,

Yakut³

et al. 2011

Turk J Gastroenterol

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Assessment of Helicobacter pylori eradication rate of triple combination therapy containing levofloxacin

Seven¹,

Çınar²,

Yakut³

et al. 2011

Turk J Gastroenterol

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show abstract

“…Recently, some studies have evaluated the efficacy of new fluoroquinolones, such as levofloxacin, that could prove to be a valid alternative to standard antibiotics, not only as first-line therapies, but more interestingly, as second-line regimens [21,[88][89][90] . In this respect, levofloxacin-based second-line therapies represent an encouraging strategy for eradication failures, as some studies have demonstrated that levofloxacin has, in vitro, remarkable activity against H pylori [91] , and that primary resistances to such an antibiotic are (still) relatively infrequent (when compared with metronidazole or clarithromycin) [92][93][94][95][96] . A recent in vitro study also showed a synergistic effect of quinolone antimicrobial agents and PPIs on strains of H pylori [97] .…”

Section: Rbc Tetracycline and Metronidazolementioning

confidence: 99%

“…A recent in vitro study also showed a synergistic effect of quinolone antimicrobial agents and PPIs on strains of H pylori [97] . Furthermore, it has been shown in vitro that levofloxacin retains its activity when H pylori strains are resistant to clarithromycin and metronidazole [95,98,99] . These favorable results have been confirmed in vivo, indicating that most of the patients with both metronidazole and clarithromycin resistance are cured with the levofloxacin-based regimen [52,94,100] .…”

Section: Rbc Tetracycline and Metronidazolementioning

confidence: 99%

“…These favorable results have been confirmed in vivo, indicating that most of the patients with both metronidazole and clarithromycin resistance are cured with the levofloxacin-based regimen [52,94,100] . A combination of a PPI, amoxicillin and levofloxacin, as a first-line regimen, has been associated with favorable results, with mean eradication rates of about 90% [95,[101][102][103][104][105][106] . Subsequently, other authors studied this same regimen in patients with one previous eradication failure, also reporting exciting results, with H pylori cure rates ranging from 60% to 94%…”

Section: Rbc Tetracycline and Metronidazolementioning

confidence: 99%

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“Rescue” regimens after Helicobacter pylori treatment failure

Gisbert¹

2008

WJG

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Helicobacter pylori (H pylori ) infection is the main cause of gastritis, gastroduodenal ulcer disease, and gastric cancer. After more than 20 years of experience in H pylori treatment, in my opinion, the ideal regimen to treat this infection is still to be found. Currently, apart from having to know first-line eradication regimens well, we must also be prepared to face treatment failures. Therefore, in designing a treatment strategy we should not focus on the results of primary therapy alone, but also on the final (overall) eradication rate. The choice of a "rescue" treatment depends on which treatment is used initially. If a clarithromycinbased regimen was used initially, a subsequent metronidazole-based treatment (quadruple therapy) may be used afterwards, and then a levofloxacinbased combination would be a third "rescue" option. Alternatively, it has recently been suggested that levofloxacin-based rescue therapy constitutes an encouraging second-line strategy, representing an alternative to quadruple therapy in patients with previous PPI-clarithromycin-amoxicillin failure, with the advantage of efficacy, simplicity and safety. In this case, a quadruple regimen may be reserved as a third-line rescue option. Finally, rifabutin-based rescue therapy constitutes an encouraging empirical fourthline strategy after multiple previous eradication failures with key antibiotics such as amoxicillin, clarithromycin, metronidazole, tetracycline, and levofloxacin. Even after two consecutive failures, several studies have demonstrated that H pylori eradication can finally be achieved in almost all patients if several rescue therapies are consecutively given. Therefore, the attitude in H pylori eradication therapy failure, even after two or more unsuccessful attempts, should be to fight and not to surrender.

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Management of Helicobacter pylori infection

2022

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Helicobacter pylori infection exhibits a wide disease spectrum ranging from asymptomatic gastritis, peptic ulcer disease, to gastric cancer. H. pylori can induce dysbiosis of gastric microbiota in the pathway of carcinogenesis and successful eradication can restore gastric homeostasis. Diagnostic testing and treatment for H. pylori infection is recommended in patients with active or past history of peptic ulcer, chronic dyspepsia, chronic non-steroidal anti-inflammatory drugs (NSAID) or aspirin use, precancerous gastric lesions, gastric cancer, mucosa-associated lymphoid tissue (MALT) lymphoma, family history of gastric cancer, family history of peptic ulcers, household family member having active H. pylori infection, iron deficiency anemia, idiopathic thrombocytopenic purpura, or vitamin B12 deficiency. Recommended first-line regimens for H. pylori eradication are classified according to clarithromycin resistance. In areas of high clarithromycin resistance (≥15%), we recommend 14-day concomitant therapy or 14-day bismuth quadruple therapy (BQT) as first-line regimen. In areas of low clarithromycin resistance (<15%), we recommend 14-day triple therapy or 14-day BQT as first-line treatment. Second-line regimens are 14-day levofloxacin triple therapy or 14-day BQT if BQT is not previously used. For patients with multiple treatment failure, antimicrobial susceptibility testing (AST) should be performed. If AST is not available, we recommend using antibiotics not previously used or for which resistance is unlikely, such as amoxicillin, tetracycline, bismuth, or furazolidone. High-dose potent proton pump inhibitor or vonoprazan is recommended to achieve adequate acid suppression. Probiotics can be used as an adjuvant treatment to reduce the side effects of antibiotics and enhance eradication rate.

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7‐Day Triple Therapy of Helicobacter pylori Infection with Levofloxacin, Amoxicillin, and High‐Dose Esomeprazole in Patients with Known Antimicrobial Sensitivity

Cited by 74 publications

References 48 publications

Assessment of Helicobacter pylori eradication rate of triple combination therapy containing levofloxacin

Assessment of Helicobacter pylori eradication rate of triple combination therapy containing levofloxacin

“Rescue” regimens after Helicobacter pylori treatment failure

Management of Helicobacter pylori infection

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