Gisbert JP, Fernández-Bermejo M, Molina-Infante J, Pérez-Gallardo B, Prieto-Bermejo AB, Mateos-Rodríguez JM, Robledo-Andrés P, González-García G
First-line triple therapy with levofloxacin for Helicobacter pylori eradication. [Journal Article]
Aliment Pharmacol Ther 2007 Aug 1; 26(3):495-500.
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).
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