A third-line levofloxacin-based rescue therapy for Helicobacter pylori eradication

Zullo, Angelo; Hassan, Cesare; Francesco, De; Lorenzetti, Roberto; Marignani, Massimo; Angeletti, Stefano; Ierardi, Enzo; Morini, Sergio

doi:10.1016/s1590-8658(03)00059-8

Cited by 110 publications

(95 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Therefore, the position in the case of therapy failure would be clear: do not readminister any of the antibiotics against which H pylori has probably become resistant [1,49] . (9) Finally, relatively high eradication rates have been obtained with empirical third-line treatment after two consecutive failures in several studies [76,[144][145][146][147][148][149][150][151][152][153][154][155][156] . H owe ve r, l i m i t e d e x p e r i e n c e s u g g e s t s t h a t endoscopy with culture and susceptibility testing may be appropriate after failure of two eradication therapies; in this situation, a non-randomized retrospective study suggests that third-line therapy directed by the results of sensitivity testing improve eradication compared to further empirical antibiotics, demonstrating that the success rate of sensitivity-directed therapy is superior to PPI-amoxicillin-rifabutin triple therapy, and therefore suggesting that endoscopy and sensitivity testing at this point may be worthwhile rather than more widespread use of rifabutin-based regimens [72] .…”

Section: Is It Necessary To Performmentioning

confidence: 99%

“…It has been suggested that levofloxacin-based therapies may also represent an alternative when two (or more) consecutive eradication treatments have failed to eradicate the infection [52,94,118,147,154,155,[162][163][164] . As an example, a recent study by Zullo et al [147] aimed to evaluate the efficacy of a levofloxacin-amoxicillin-PPI combination in patients who previously had failed two or more therapeutic attempts, and they found the eradication rate was 83% (intention-to-treat analysis).…”

Section: Levofloxacin-based Rescue Regimensmentioning

confidence: 99%

“…As an example, a recent study by Zullo et al [147] aimed to evaluate the efficacy of a levofloxacin-amoxicillin-PPI combination in patients who previously had failed two or more therapeutic attempts, and they found the eradication rate was 83% (intention-to-treat analysis). More recently, Gisbert et al [155] evaluated, in a multicenter study including 100 patients, the efficacy of a third-line levofloxacinbased regimen in patients with two consecutive H pylori eradication failures.…”

Section: Levofloxacin-based Rescue Regimensmentioning

confidence: 99%

See 2 more Smart Citations

“Rescue” regimens after Helicobacter pylori treatment failure

Gisbert¹

2008

WJG

View full text Add to dashboard Cite

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.

show abstract

Section: Is It Necessary To Performmentioning

confidence: 99%

Section: Levofloxacin-based Rescue Regimensmentioning

confidence: 99%

Section: Levofloxacin-based Rescue Regimensmentioning

confidence: 99%

See 1 more Smart Citation

“Rescue” regimens after Helicobacter pylori treatment failure

Gisbert¹

2008

WJG

View full text Add to dashboard Cite

show abstract

“…Baseado em vários estudos internacionais (16,17,26) e mesmo na ausência de estudos nacionais, o Consenso recomenda o emprego da associação de levofloxacina, amoxicilina e IBP como terapêutica de retratamento de segunda opção. A recomendação do emprego da associação de levofloxacina, furazolidona e IBP em dose única diária baseou-se em estudo piloto nacional com excelentes resultados iniciais (4) .…”

Section: Comentáriosunclassified

II Consenso Brasileiro sobre Helicobacter pylori

Coelho

Zaterka

2005

Arq. Gastroenterol.

View full text Add to dashboard Cite

INTRODUÇÃODesde sua identificação por MARSHALL e WARREN (13) , em 1982, O Helicobacter pylori (HP) rapidamente se tornou alvo de incontáveis estudos microbiológicos, histológicos, epidemiológicos, imunológicos, ecológicos e clínicos, entre outros. Conseqüentemente, em curto período de tempo, os avanços do conhecimento na área puderam ser utilizados, de forma revolucionária, na prática médica diária de clínicos e gastroenterologistas. O alcance desta descoberta pode ser avaliado pelo resultado de inquérito recente entre gastroenterologistas, onde tal descoberta foi considerada a mais importante da especialidade no último século (8) .Com o objetivo de orientar os médicos nas várias questões relacionadas ao manuseio da infecção pelo HP, diferentes reuniões de consenso têm sido realizadas em todo o mundo (1,5,10,12,15,23) . No Brasil, em 1995, durante o Congresso Panamericano de Enfermedades Digestivas, realizado em Belo Horizonte, MG, foi realizado o "Consenso Nacional sobre H. pylori e afecções associadas" (2) .A

show abstract

“…23 (Table 5). 23,56,[61][62][63][64] 5. Rifabutin 포함 삼제 요법 H. pylori 제균 치료에 실패했을 경우 치료의 대안으로 rifabutin을 포함한 제균 치료가 제안되었다.…”

unclassified

Trend for Treatment ofHelicobacter pyloriin Overseas Country

Kang

Lim

2012

Korean J Helicobacter Up Gastrointest Res

View full text Add to dashboard Cite

Management ofHelicobacter pylori infection is still a challenging matter. The aim of eradication of H. pylori is to cure peptic ulcer and decrease the risk of gastric cancer. The prevalence of H. pylori infection is high in developing countries and the burden of gastric cancer in developing countries is large since H. pylori has the potential to increase the risk of gastric cancer. Over the past decade, the efficacy of the standard first-line triple therapy has declined and increased resistance to antibiotics, especially clarithromycin, is considered the most important cause. Attempts to overcome eradication failure have been made. Sequential therapy, quadruple therapy and various combinations of new (quinolone or rifabutin) and old antibiotics have been introduced. This review will give an overview on the dramatic fall in eradication rates all over the world and introduce newer attempts providing promising results.

show abstract

A third-line levofloxacin-based rescue therapy for Helicobacter pylori eradication

Cited by 110 publications

References 27 publications

“Rescue” regimens after Helicobacter pylori treatment failure

“Rescue” regimens after Helicobacter pylori treatment failure

II Consenso Brasileiro sobre Helicobacter pylori

Trend for Treatment ofHelicobacter pyloriin Overseas Country

Contact Info

Product

Resources

About