BACKGROUND: The standard first-line therapies for Helicobacter pylori eradication are based on clarithromycin and amoxicillin or metronidazole. Recent studies suggested levofloxacin as an alternative option for both first-and second-line H. pylori eradication treatment. AIMS: To compare efficacy and tolerability of two different 7-day standard triple therapies versus 7-day levofloxacin-based triple therapy in first-line treatment for H. pylori infection. METHODS: Three hundred consecutive H. pylori positive patients were randomized to receive: clarithromycin, amoxicillin, esomeprazole (Group A: N = 100); clarithromycin, metronidazole, esomeprazole (Group B: N = 100); or clarithromycin, levofloxacin, esomeprazole (Group C: N = 100). H. pylori status was rechecked by (13)C urea breath test 6 wk after the end of therapy. RESULTS: Sixteen out of 300 patients discontinued treatment because of the occurrence of side effects (Group A, 5; Group B, 7; Group C, 4). The eradication rates in intention to treat (ITT) and per protocol (PP) analyses were: Group A, 75% and 79%; Group B, 72% and 77.4%; and Group C, 87% and 90.6%. The eradication rate achieved with levofloxacin-based triple therapy was significantly higher than that with standard therapies in either ITT (87%vs 75%, p <0.05; 87%vs 72%, p <0.01;) or PP analysis (90.6%vs 79%, p <0.05; 90.6 vs 77.4, p <0.05). No difference was found between standard triple therapies. The incidence of side effects was similar among groups. CONCLUSIONS: A 7-day levofloxacin-based triple therapy can achieve higher H. pylori eradication rates than standard regimens. These data suggest levofloxacin-based regimens can be the most effective in first-line anti-H. pylori therapy, at least in the Italian population.

Nista, E., Candelli, M., Zocco, M. A., Cremonini, F., Ojetti, V., Finizio, R., Spada, C., Cammarota, G., Gasbarrini, G. B., Gasbarrini, A., Levofloxacin-based triple therapy in first-line treatment for Helicobacter pylori eradication, <<THE AMERICAN JOURNAL OF GASTROENTEROLOGY>>, 2006; 101 (9): 1985-1990. [doi:10.1111/j.1572-0241.2006.00716.x] [http://hdl.handle.net/10807/21099]

Levofloxacin-based triple therapy in first-line treatment for Helicobacter pylori eradication

Candelli, Marcello;Zocco, Maria Assunta;Cremonini, Filippo;Ojetti, Veronica;Finizio, Rosalba;Spada, Cristiano;Cammarota, Giovanni;Gasbarrini, Giovanni Battista;Gasbarrini, Antonio
2006

Abstract

BACKGROUND: The standard first-line therapies for Helicobacter pylori eradication are based on clarithromycin and amoxicillin or metronidazole. Recent studies suggested levofloxacin as an alternative option for both first-and second-line H. pylori eradication treatment. AIMS: To compare efficacy and tolerability of two different 7-day standard triple therapies versus 7-day levofloxacin-based triple therapy in first-line treatment for H. pylori infection. METHODS: Three hundred consecutive H. pylori positive patients were randomized to receive: clarithromycin, amoxicillin, esomeprazole (Group A: N = 100); clarithromycin, metronidazole, esomeprazole (Group B: N = 100); or clarithromycin, levofloxacin, esomeprazole (Group C: N = 100). H. pylori status was rechecked by (13)C urea breath test 6 wk after the end of therapy. RESULTS: Sixteen out of 300 patients discontinued treatment because of the occurrence of side effects (Group A, 5; Group B, 7; Group C, 4). The eradication rates in intention to treat (ITT) and per protocol (PP) analyses were: Group A, 75% and 79%; Group B, 72% and 77.4%; and Group C, 87% and 90.6%. The eradication rate achieved with levofloxacin-based triple therapy was significantly higher than that with standard therapies in either ITT (87%vs 75%, p <0.05; 87%vs 72%, p <0.01;) or PP analysis (90.6%vs 79%, p <0.05; 90.6 vs 77.4, p <0.05). No difference was found between standard triple therapies. The incidence of side effects was similar among groups. CONCLUSIONS: A 7-day levofloxacin-based triple therapy can achieve higher H. pylori eradication rates than standard regimens. These data suggest levofloxacin-based regimens can be the most effective in first-line anti-H. pylori therapy, at least in the Italian population.
Inglese
Nista, E., Candelli, M., Zocco, M. A., Cremonini, F., Ojetti, V., Finizio, R., Spada, C., Cammarota, G., Gasbarrini, G. B., Gasbarrini, A., Levofloxacin-based triple therapy in first-line treatment for Helicobacter pylori eradication, <>, 2006; 101 (9): 1985-1990. [doi:10.1111/j.1572-0241.2006.00716.x] [http://hdl.handle.net/10807/21099]
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/10807/21099
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