The Efficacy of Second‐Line Anti‐<i>Helicobacter pylori</i> Therapy Using an Extended 14‐Day Levofloxacin/Amoxicillin/Proton‐Pump Inhibitor Treatment – A Pilot Study

Chuah, Seng‐Kee; Tai, Wei‐Chen; Hsu, Pin‐I; Wu, Deng‐Chyang; Wu, Keng‐Liang; Kuo, Chien-Lin; Chiu, Yi‐Chun; Hu, Ming‐Luen; Chou, Yeh‐Pin; Kuo, Yuan-Hung; Liang, Chih‐Ming; Chiu, King-Wah; Hu, Tsung–Hui

doi:10.1111/j.1523-5378.2012.00960.x

Cited by 72 publications

(51 citation statements)

References 37 publications

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“…We found eleven RCTs, published since 2000, that had compared 14-day bismuth quadruple therapy with other regimens as salvage treatment; one was conducted in the United States ( 177 ), three in Europe ( 175,176,178 ) and the remaining seven in Asia ( 173,(179)(180)(181)(182)(183)(184). Eight of these studies only included patients who failed eradication once, aft er treatment with clarithromycin triple therapy.…”

Section: Bismuth-quadruple Regimenmentioning

confidence: 99%

“…Only one of these studies assessed 14-day levofl oxacin triple therapy; it was conducted in Taiwan, among 101 patients who had failed treatment with 7 day clarithromycin triple therapy, and found no diff erence in eradication rates between 14-day levofl oxacin triple therapy (86%; 95% CI 77-96%) and 14-day bismuth quadruple (PBMT, 86%; 76-96%) ( 181 ). Four RCTs assessed the 10-day levofl oxacin triple therapy regimen ( 176,(185)(186)(187); all were conducted in Europe and the pooled eradication rate was 84% (73-92%).…”

Section: Levofl Oxacin Triple Regimen (Ppi Amoxicillin Levofl Oxacimentioning

confidence: 99%

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ACG Clinical Guideline: Treatment of Helicobacter pylori Infection

Chey

Leontiadis

Howden

et al. 2017

American Journal of Gastroenterology

1,182

1,379

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Helicobacter pylori ( H. pylori ) infection is a common worldwide infection that is an important cause of peptic ulcer disease and gastric cancer. H. pylori may also have a role in uninvestigated and functional dyspepsia, ulcer risk in patients taking low-dose aspirin or starting therapy with a non-steroidal anti-infl ammatory medication, unexplained iron defi ciency anemia, and idiopathic thrombocytopenic purpura. While choosing a treatment regimen for H. pylori , patients should be asked about previous antibiotic exposure and this information should be incorporated into the decision-making process. For fi rst-line treatment, clarithromycin triple therapy should be confi ned to patients with no previous history of macrolide exposure who reside in areas where clarithromycin resistance amongst H. pylori isolates is known to be low. Most patients will be better served by fi rst-line treatment with bismuth quadruple therapy or concomitant therapy consisting of a PPI, clarithromycin, amoxicillin, and metronidazole. When fi rst-line therapy fails, a salvage regimen should avoid antibiotics that were previously used. If a patient received a fi rst-line treatment containing clarithromycin, bismuth quadruple therapy or levofl oxacin salvage regimens are the preferred treatment options. If a patient received fi rst-line bismuth quadruple therapy, clarithromycin or levofl oxacin-containing salvage regimens are the preferred treatment options. Details regarding the drugs, doses and durations of the recommended and suggested fi rst-line and salvage regimens can be found in the guideline. Asia and Central and South America ( 8,22 ). Th ere is, however, preliminary evidence that it may be falling in some previously high prevalence areas ( 22 ). People immigrating to North America from Asia and other parts of the world have a much higher prevalence of the infection than people born in North America ( 23 ). In one study, the seroprevalence among immigrants from East Asia was 70.1% ( 24 ). Hispanic immigrants to North America have higher rates of the infection than fi rst-or second-generation Hispanics who were born here ( 25 ). QUESTION 2: WHAT ARE THE INDICATIONS TO TEST FOR, AND TO TREAT, H. PYLORI INFECTION? RecommendationsSince all patients with a positive test of active infection with H. pylori should be off ered treatment, the critical issue is which patients should be tested for the infection (strong recommendation, quality of evidence: not applicable), All patients with active peptic ulcer disease (PUD), a past history of PUD (unless previous cure of H. pylori infection has been documented), low-grade gastric mucosa-associated lymphoid tissue (MALT) lymphoma, or a history of endoscopic resection of early gastric cancer (EGC) should be tested for H. pylori infection. Th ose who test positive should be off ered treatment for the infection (strong recommendation, quality of evidence: high for active or history of PUD, low for MALT lymphoma, low for history of endoscopic resection of EGC).In patients with uninvestigated d...

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Section: Bismuth-quadruple Regimenmentioning

confidence: 99%

Section: Levofl Oxacin Triple Regimen (Ppi Amoxicillin Levofl Oxacimentioning

confidence: 99%

ACG Clinical Guideline: Treatment of Helicobacter pylori Infection

Chey

Leontiadis

Howden

et al. 2017

American Journal of Gastroenterology

1,182

1,379

View full text Add to dashboard Cite

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“…Worth noting is that such a therapy achieved an encouragingly high (87.5%) eradication rate. A similarly prolonged levofloxacin-based triple, with double-dose PPI, achieved 84.8-93.6% success rates in Taiwan [24,25]. However, when a regimen with increased doses was administered for only 8 days, the eradication rate was only 60-64% [26].…”

Section: Discussionmentioning

confidence: 99%

Two-week Triple Therapy with either Standard or High-dose Esomeprazole for First-line H. pylori Eradication

Francesco

Hassan

Bellesia

et al. 2016

JGLD

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Background & Aims: The updated Italian guidelines advise a standard 14-day triple therapy for first-line H. pylori eradication. This prospective study evaluated the cure rate following a 14-day triple therapy with either a standard or double-dose proton pump inhibitor (PPI). Methods. A total of 145 consecutive patients with H. pylori infection were randomized to receive a 14-day, first-line triple therapy with clarithromycin 500 mg, amoxicillin 1 g and esomeprazole at either 20 mg (standard therapy) or 40 mg (double-dose therapy), each given twice daily. Results. At intention-to-treat analysis, H. pylori infection was cured in 73.9% (95% CI: 63.9−84) and 81.9% (95% CI: 73−90.8) following standard and double-dose therapy, respectively, and in 78.2% (95% CI: 68.5−87.9) and 85.5% (95% CI: 77.2−93.8) at per-protocol analysis. No statistically significant difference occurred. Overall, 16.4% and 19.4% patients in the standard and double-dose therapy regimen complained of side effects. Conclusion. The success rate of both standard and double-dose 14-day triple therapies for first-line H. pylori treatment was unsatisfactory. A prolonged 14-day levofloxacin-based triple therapy for second-line H. pylori eradication seems to be promising. Abbrevations: ITT: Intention To Treat; NUD: non ulcer dyspepsia; PP: PerAdd Contributor Protocol; PPI: proton pump inhibitors; PUD: peptic ulcer disease; UBT: urea breath test.

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“…The efficacy of existing treatment against H. pylori is decreased due to increasing resistance against almost all antibiotics used in the treatment (Chuah et al, 2012;De Francesco et al, 2012;Graham and Fischbach, 2010). Therefore, there is an urgent need to identify new drug targets and discover drugs to combat ever growing drug resistant bacteria.…”

Section: Introductionmentioning

confidence: 98%

Structural and biochemical characterization of GTP cyclohydrolase II from Helicobacter pylori reveals its redox dependent catalytic activity

Yadav

Karthikeyan

2015

Journal of Structural Biology

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The Efficacy of Second‐Line Anti‐Helicobacter pylori Therapy Using an Extended 14‐Day Levofloxacin/Amoxicillin/Proton‐Pump Inhibitor Treatment – A Pilot Study

Abstract: A 14-day levofloxacin/amoxicillin/esomeprazole triple therapy approach provides a >90% per-protocol report card with the caveat that this approach is markedly less effective in the presence of fluoroquinolone resistance. Levofloxacin-resistant strains are increasing in Taiwan.

Cited by 72 publications

References 37 publications

ACG Clinical Guideline: Treatment of Helicobacter pylori Infection

ACG Clinical Guideline: Treatment of Helicobacter pylori Infection

Two-week Triple Therapy with either Standard or High-dose Esomeprazole for First-line H. pylori Eradication

Structural and biochemical characterization of GTP cyclohydrolase II from Helicobacter pylori reveals its redox dependent catalytic activity

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