Levofloxacin based triple therapy as a second-line treatment after failure of Helicobacter pylori eradication with standard triple therapy

Watanabe, Yoshihisa; Aoyama, Nobuo; Shirasaka, Daisuke; Maekawa, Satoshi; Kuroda, Kohei; Miki, Ikuya; Kachi, Masaaki; Fukuda, Misao; Wambura, Casmir; Tamura, Takao; Kasuga, Masato

doi:10.1016/s1590-8658(03)00432-8

Cited by 82 publications

(59 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…However, because of the administration of four drugs with a complex scheme and high incidence of adverse effects, levofloxacin was used as a second-line rescue therapy as an alternative. Levofloxacin may retain its activity when Hp strains are resistant to clarithromycin and metronidazole (17,30). These 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 (31)(32)(33).…”

Section: Discussionmentioning

confidence: 82%

Comparison of 7- and 14-day first-line therapies including levofloxacin in patients with Helicobacter pylori positive non-ulcer dyspepsia

Erçin¹,

Uygun²,

Toros³

et al. 2010

Turk J Gastroenterol

View full text Add to dashboard Cite

Helicobacter pylori (Hp) infection causes gastritis and gastroduodenal ulcer disease and is also associated with mucosa-associated lymphoid tissue (MALT) lymphoma and gastric cancer. In more than 20 years, researchers dealing with the eradication of this pathogen have been unable to find the ideal protocol, because the generally accepted minimum success rate of treatment regimens for Hp eradication is 80% (1, 2).The current standard first-line treatment to eradicate Hp is triple therapy, combining a proton pump inhibitor (PPI) with two antibiotics, mainly clarithromycin (500 mg b.i.d.) and amoxicillin (1 g b.i.d.) or metronidazole (500 mg b.i.d.), according Turk J Gastroenterol 2010; 21 (1): 12-16

show abstract

Section: Discussionmentioning

confidence: 82%

Comparison of 7- and 14-day first-line therapies including levofloxacin in patients with Helicobacter pylori positive non-ulcer dyspepsia

Erçin¹,

Uygun²,

Toros³

et al. 2010

Turk J Gastroenterol

View full text Add to dashboard Cite

show abstract

“…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%

“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

“…A recent in vitro study also showed a synergistic effect of quinolone antimicrobial agents and PPIs on strains of H. pylori [Tanaka et al 2002]. Furthermore, it has been shown in vitro that levofloxacin retains its activity when H. pylori strains are resistant to clarithromycin and metronidazole [Antos et al 2006;Yahav et al 2006b;Watanabe et al 2003]. 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 [Gatta et al 2005;Matsumoto et al 2005;Bilardi et al 2004].…”

Section: Introductionmentioning

confidence: 99%

Review: Second-line rescue therapy of Helicobacter pylori infection

Gisbert

2009

Therap Adv Gastroenterol

View full text Add to dashboard Cite

Helicobacter pylori infection is the main known cause of gastritis, gastroduodenal ulcer disease and gastric cancer. After more than 20 years of experience in H. pylori treatment, however, the ideal regimen to treat this infection has still to be found. Nowadays, apart from having to know well first-line eradication regimens, 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 first-line clarithromycin-based regimen was used, a second-line metronidazole-based treatment (quadruple therapy) may be used afterwards, and then a levofloxacin-based combination would be a third-line '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, quadruple regimen may be reserved as a third-line 'rescue' option. Finally, rifabutin-based 'rescue' therapy constitutes an encouraging empirical fourth-line 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

Levofloxacin based triple therapy as a second-line treatment after failure of Helicobacter pylori eradication with standard triple therapy

Cited by 82 publications

References 24 publications

Comparison of 7- and 14-day first-line therapies including levofloxacin in patients with Helicobacter pylori positive non-ulcer dyspepsia

Comparison of 7- and 14-day first-line therapies including levofloxacin in patients with Helicobacter pylori positive non-ulcer dyspepsia

“Rescue” regimens after Helicobacter pylori treatment failure

Review: Second-line rescue therapy of Helicobacter pylori infection

Contact Info

Product

Resources

About