Efficacy of two different dosages of levofloxacin in curing Helicobacter pylori infection: A Prospective, Single-Center, randomized clinical trial

Gan, Huo-Ye; Tie-li, Peng; Huang, Yue; Su, Kai-Hua; Zhao, Lei; Yao, Liya; Yang, Rong-Jiao

doi:10.1038/s41598-018-27482-2

Cited by 12 publications

(7 citation statements)

References 23 publications

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“…The results showed the superiority of oral levofloxacin 200 mg twice daily to oral levofloxacin 500 mg once daily for the eradication of H. pylori infection. [ 23 ] Other studies have recommended 500 mg levofloxacin once daily for H. pylori infection eradication. [ 24 ] Qian et al .…”

Section: Discussionmentioning

confidence: 99%

The comparison of levofloxacin- and clarithromycin-based bismuth quadruple therapy regimens in Helicobacter pylori eradication

et al. 2020

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Objective: The aim of the current study was to compare the efficacy of quadruple therapy including levofloxacin and clarithromycin for Helicobacter pylori eradication. Methods: This clinical trial study was conducted on 189 patients with H. pylori infection who underwent gastroscopy and stomach biopsy in Shahid Beheshti Hospital, Kashan, Iran. After classification of patients, one group was treated with bismuth subcitrate (120 mg, 2 tablet/12 h), omeprazole (20 mg/12 h), amoxicillin (1 g/12 h), and clarithromycin (500 mg/12 h) and other group with bismuth subcitrate (120 mg, 2 tablet/12 h), omeprazole (20 mg/12h), amoxicillin (1 g/12 h), and levofloxacin (500 mg/12 h) for 2 weeks. After the end of the antibiotic treatment, omeprazole therapy was continued for 4 weeks. Two weeks after discontinuation of omeprazole, fecal antigen test was performed for both the groups to confirm the eradication of H. pylori infection. Findings: The success of H. pylori eradication in the levofloxacin and clarithromycin groups was observed in 78 (89.7%) and 71 (69.6%) patients, respectively ( P < 0.01). A significant difference was also seen between the two groups in terms of side effects and its incidence ( P < 0.01), so that the incidence of side effect types in the clarithromycin group was more than the levofloxacin group except muscular pain and fatigue ( P < 0.01). Conclusion: Levofloxacin-based quadruple regimen therapy was superior to clarithromycin-based quadruple regimens regarding H. pylori eradication and side effects. Therefore, the levofloxacin-based regimen can be considered as an effective treatment for the first-line anti- H. pylori therapy.

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Section: Discussionmentioning

confidence: 99%

The comparison of levofloxacin- and clarithromycin-based bismuth quadruple therapy regimens in Helicobacter pylori eradication

et al. 2020

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“…Once-daily 14-and 7-day levofloxacin dosing regimens (levofloxacin, clarithromycin, rabeprazole, and bismuth) have shown eradication rates of 94% and 84%, respectively [77]. Gan et al compared the efficacy of different dosages of levofloxacin for the eradication of H. pylori [78]. The eradication rates in the once-and twice-daily groups were 77.5% and 79.5% (ITT) and 82.9% and 86.4% (PP), respectively [78].…”

Section: Levofloxacin-based Therapymentioning

confidence: 99%

“…Gan et al compared the efficacy of different dosages of levofloxacin for the eradication of H. pylori [78]. The eradication rates in the once-and twice-daily groups were 77.5% and 79.5% (ITT) and 82.9% and 86.4% (PP), respectively [78]. There are no significant differences in the eradication or compliance rate.…”

Section: Levofloxacin-based Therapymentioning

confidence: 99%

Best Helicobacter pylori Eradication Strategy in the Era of Antibiotic Resistance

Kim

Chung

2020

Antibiotics

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Antibiotic resistance is the major reason for Helicobacter pylori treatment failure, and the increasing frequency of antibiotic resistance is a challenge for clinicians. Resistance to clarithromycin and metronidazole is a particular problem. The standard triple therapy (proton pump inhibitor, amoxicillin, and clarithromycin) is no longer appropriate as the first-line treatment in most areas. Recent guidelines for the treatment of H. pylori infection recommend a quadruple regimen (bismuth or non-bismuth) as the first-line therapy. This treatment strategy is effective for areas with high resistance to clarithromycin or metronidazole, but the resistance rate inevitably increases as a result of prolonged therapy with multiple antibiotics. Novel potassium-competitive acid blocker-based therapy may be effective, but the data are limited. Tailored therapy based on antimicrobial susceptibility test results is ideal. This review discussed the current important regimens for H. pylori treatment and the optimum H. pylori eradication strategy.

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“…37 In Iran, a 10day sequential regimen using levofloxacin was found to have a 78% A randomized controlled trial from China looked at different dosages of levofloxacin as part of a bismuth quadruple regimen and found that 200 mg dosing, which achieved eradication in 79% of cases, was non-inferior to 500 mg dosages where 77% were cured, which has obvious cost and potential side effect implications.…”

Section: Le Voflox Acin -Ba S Ed Ther Apymentioning

confidence: 99%

“…A randomized controlled trial from China looked at different dosages of levofloxacin as part of a bismuth quadruple regimen and found that 200 mg dosing, which achieved eradication in 79% of cases, was non-inferior to 500 mg dosages where 77% were cured, which has obvious cost and potential side effect implications. 37 In Iran, a 10day sequential regimen using levofloxacin was found to have a 78% success rate compared to an 83% cure rate for 14-day quadruple therapy. 38 Finally, two studies compared levofloxacin-based therapy to standard triple therapy.…”

Section: Le Voflox Acin -Ba S Ed Ther Apymentioning

confidence: 99%

Review: Treatment of Helicobacter pylori Infection 2019

et al. 2019

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This review summarizes important studies regarding Helicobacter pylori therapy published from May 2018 to May 2019. The main themes that emerge involve studies assessing the efficacy of bismuth‐based regimens. While in recent years the efficacy of bismuth‐based quadruple therapy as a second‐line therapy has been clearly established, there is now substantial evidence that it is the best performing first‐line therapy. Antibiotic resistance was again intensely studied this year, and a clear and dramatic increase in resistance is noted for clarithromycin and levofloxacin; most notably, it may not be possible to support these therapies in most regions of the world much longer without testing. The utility of vonoprazan as an alternative to proton‐pump inhibitor therapy, especially in resistant and difficult to treat groups, has also been considered in greater detail this year, as well as means of supporting and enhancing adherence to therapy. Several studies showed that the diversity of gut microbiota was significantly altered shortly after H pylori eradication. However, the diversity was restored to pre‐treatment state after 2 months in patients treated with triple therapy. More studies are warranted to assess the long‐term changes of gut microbiota after H pylori eradication.

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Efficacy of two different dosages of levofloxacin in curing Helicobacter pylori infection: A Prospective, Single-Center, randomized clinical trial

Cited by 12 publications

References 23 publications

The comparison of levofloxacin- and clarithromycin-based bismuth quadruple therapy regimens in Helicobacter pylori eradication

The comparison of levofloxacin- and clarithromycin-based bismuth quadruple therapy regimens in Helicobacter pylori eradication

Best Helicobacter pylori Eradication Strategy in the Era of Antibiotic Resistance

Review: Treatment of Helicobacter pylori Infection 2019

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