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First‐line triple therapy with levofloxacin for Helicobacter pylori eradication
Author(s) -
GISBERT J. P.,
FERNÁNDEZBERMEJO M.,
MOLINAINFANTE J.,
PÉREZGALLARDO B.,
PRIETOBERMEJO A.B.,
MATEOSRODRÍGUEZ J.M.,
ROBLEDOANDRÉS P.,
GONZÁLEZGARCÍA G.
Publication year - 2007
Publication title -
alimentary pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.308
H-Index - 177
eISSN - 1365-2036
pISSN - 0269-2813
DOI - 10.1111/j.1365-2036.2007.03384.x
Subject(s) - medicine , levofloxacin , amoxicillin , helicobacter pylori , clarithromycin , tolerability , regimen , proton pump inhibitor , adverse effect , gastroenterology , breath test , ranitidine , antibiotics , microbiology and biotechnology , biology
Summary Background At present, the efficacy of proton pump inhibitor‐clarithromycin‐amoxicillin regimen is relatively low. Aim To evaluate the efficacy and tolerability of a first‐line triple clarithromycin‐free regimen including ranitidine bismuth citrate, levofloxacin and amoxicillin. Methods Design : Prospective study. Patients : Helicobacter pylori ‐positive patients complaining of dyspeptic symptoms referred for gastroscopy. Intervention : Levofloxacin (500 mg b.d.), amoxicillin (1 g b.d.) and ranitidine bismuth citrate (400 mg b.d.) was prescribed for 10 days. Outcome : Eradication was confirmed by a 13 C‐urea breath test 8 weeks after therapy. Compliance with therapy was determined by questioning and the recovery of empty envelopes of medications. Incidence of adverse effects was evaluated by means of a specific questionnaire. Results Sixty‐four patients were included (30% peptic ulcer, 70% functional dyspepsia). Almost all (97%) patients took all the medications correctly. Per‐protocol and intention‐to‐treat eradication rates were 88.5% (95% CI =78–95%) and 84.4 (74–91%). Adverse effects were reported in 9.5% of the patients, mainly including diarrhoea (7.9%); none of them were severe. Conclusion This new 10‐day levofloxacin‐based combination represents an alternative to clarithromycin‐based therapy, as it meets the criteria set for regimens used as primary H. pylori treatment: effectiveness (>80%), simplicity (twice‐daily dosing and excellent compliance) and safety (low incidence of adverse effects).