Comparison of levofloxacin-containing sequential and standard triple therapies for the eradication of Helicobacter pylori

Polat, Zülfıkar; Kadayıfçı, Abdurrahman; Kantarcıoğlu, Murat; Özcan, Ayhan; Emer, Özdeş; Uygun, Ahmet

doi:10.1016/j.ejim.2011.02.011

Cited by 33 publications

(37 citation statements)

References 28 publications

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“…These studies reported a marked decrease in the success of standard eradication regimens because of increased clarithromycin resistance [8,17,18,19]. Our results have also supported these results (48.3% PP and 42% ITT in the PAC group).…”

Section: Discussionsupporting

confidence: 82%

Current Status of Five Different Regimens for Empiric First-Line Helicobacter pylori Eradication in Turkey

Güngör¹,

Baglicakoglu

Kayaçeti̇n

et al. 2015

Digestion

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Background/Aims: This study aimed at comparing the efficacy and tolerability of 5 different regimens for Helicobacter pylori eradication in recent years. Methods:H. pylori-positive patients with dyspeptic symptoms were included and separated into 5 groups. The ‘PAC group' was given pantoprazole, amoxicillin and clarithromycin for 14 days. The ‘PAM group' was given pantoprazole, amoxicillin and metronidazole for 14 days. The ‘bismuth-containing group' was given pantoprazole, bismuth subsalicylate, tetracycline and metronidazole for 14 days. The ‘sequential group' was given pantoprazole and amoxicillin for 5 days, followed by pantoprazole, tetracycline, and metronidazole for the next 5 days. The ‘concomitant group' was given pantoprazole, amoxicillin, tetracycline, and metronidazole for 10 days. Eradication was assessed through the urea breath test on 6 weeks after eradication therapy. Results: The eradication rate of intention-to-treat/per protocol were 42/48.3% in the PAC group, 52/54.2% in the PAM group, 62/77.5% in the bismuth group, 71/80.7% in the sequential group and 72/83.7% in concomitant group. The frequency of mild and moderate side effects was similar between groups. Conclusion: The concomitant and sequential therapies are an effective treatment for H. pylori. Bismuth-containing therapy is superior to conventional triple therapies; however, the eradication rate is not satisfactory. In our country, conventional triple therapies are not effective for eradication.

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Section: Discussionsupporting

confidence: 82%

Current Status of Five Different Regimens for Empiric First-Line Helicobacter pylori Eradication in Turkey

Güngör¹,

Baglicakoglu

Kayaçeti̇n

et al. 2015

Digestion

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“…It has been suggested that levofloxacin rather than clarithromycin can also offer superior eradication in sequential regimes. This was again illustrated in a study from Turkey, which showed superior eradication for 10-day sequential therapy, (90% cure rate), over 14-day triple therapy (57% cure rate) [18]. In India, a study looked at the efficacy of sequential therapy in patients after perforated duodenal ulcer and found superior cure rates for sequential therapy compared to 10-day triple therapy (87.03% and 81.25%) [19].…”

Section: Triple Therapymentioning

confidence: 99%

Treatment of Helicobacter pylori infection 2012

et al. 2012

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Helicobacter pylori resistance rates to antibiotics vary in different countries and even in different regions of the same country. Choice of treatment is strongly dependent on antibiotic resistance rates. In some countries, triple therapy with a proton-pump inhibitor, amoxicillin, and clarithromycin is still the best option, but eradication results fall short of what would be desired (90-95%) in countries with clarithromycin resistance >20%, bismuth-containing quadruple therapy, or nonbismuth sequential or concomitant therapies may then be the preferred option. Newer antibiotic regimens are awaited. Vaccination would be the best option, especially for developing countries, but little progress has been made in designing a vaccine.A considerable amount of work has been conducted over the last year assessing many issues around Helicobacter pylori eradication therapy. These focussed primarily on assessing the efficacy of current standard triple therapy and exploring new first-line treatments. There was also progress in investigating antibiotic resistance rates, and the rescue therapies required to deal with ensuing treatment failures. There has also been an evolution in the use of adjunctive therapies. This article will address the published literature over the last year pertaining to these topics. Triple TherapyNumerous studies over the last year have assessed the efficacy of standard triple therapy with amoxicillin, clarithromycin, and a proton-pump inhibitor for the eradication of H. pylori, which have been perceived to be in decline in recent years. One such study looked at cure rates reported in all published literature from Spain between 1997 and 2008 and found that while cure rates have in fact been stable over that period, they remain inadequate with a mean cure rate of 80% by intention-to-treat and 83% by per-protocol [1]. Similar results were obtained from a multicenter study in Japan that revealed an eradication rate of 80.7% with an incidence of adverse drug reactions of 4.4% [2]. Other studies have looked at whether the efficacy of triple therapy can be improved by prolonging the course of therapy. In China, a study of shorter regimens showed eradication rates of 76, 89, and 91% for 3-day, 5-day, and 7-day regimens, respectively [3]. Increasing efficacy by prolongation of therapy was also noted in Greek patients, with eradication rates of 74.5% for 7 days, 80.6% for 10 days, and 90.2% for 14 days of therapy [4]. Another study showed that efficacy could be maintained when lower doses of medications were given, which reduced costs and side effects with cure rates of 77.2% for 10 mg rabeprazole, 500 mg amoxicillin, and 250 mg clarithromycin vs 78.9% for the standard 20 mg, 1 g, and 500 mg doses of these drugs [5].Regardless of the type of therapy used, study from Canada showed widespread failure to comply with test and treat in up to 10% of cases and a failure to confirm eradication in 32% [6]. This illustrates that efficacious first-line therapy will always depend on adherence to guidelines by phy...

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“…the standard triple therapy (PPI, clarithromycin, and amoxicillin) have fallen below 45-60% in the last 10 years because of which this therapy is no longer recommended as the firstline therapy [22][23][24]. Therefore, there is a need for new and reasonable antibiotic regimens in Turkey that can eradicate H. pylori cost-effectively without increasing the side effects.…”

Section: Discussionmentioning

confidence: 99%

Different bismuth-based therapies for eradicating Helicobacter pylori: Randomized clinical trial of efficacy and safety

Gökcan¹,

Öztaş²,

Önal³

2016

Clinics and Research in Hepatology and Gastroenterology

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Comparison of levofloxacin-containing sequential and standard triple therapies for the eradication of Helicobacter pylori

Cited by 33 publications

References 28 publications

Current Status of Five Different Regimens for Empiric First-Line <b><i>Helicobacter pylori</i></b> Eradication in Turkey

Current Status of Five Different Regimens for Empiric First-Line <b><i>Helicobacter pylori</i></b> Eradication in Turkey

Treatment of Helicobacter pylori infection 2012

Different bismuth-based therapies for eradicating Helicobacter pylori: Randomized clinical trial of efficacy and safety

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