首页|Levofloxacin/amoxicillin-based schemes vs quadruple therapy for Helicobacter pylori eradication in second-line

Levofloxacin/amoxicillin-based schemes vs quadruple therapy for Helicobacter pylori eradication in second-line

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Worldwide prevalence of Helicobacter pylori (H.pylori)infection is approximately 50％,with the highest being in developing countries.We compared cure rates and tolerability (SE) of second-line anti-H,pylori levofloxacin/amoxicillin (LA)-based triple regimens vs standard quadruple therapy (QT).An English language literature search was performed up to October 2010.A meta-analysis was performed including randomized clinical trials comparing 7-or 10-d LA with 7-d QT.In total,10 articles and four abstracts were identified.Overall eradication rate in LA was 76.5％ (95％CI:64.4％-97.6％).When only 7-d regimens were included,cure rate was 70.6％ (95％ CI:40.2％-99.1％),whereas for 10-d combinations,cure rate was significantly higher (88.7％; 95％ CI:56.1％-109.9％;P ＜ 0.05).Main eradication rate for QT was 67.4％ (95％ CI:49.7％-67.9％).The 7-d LA and QT showed comparable efficacy [odds ratio (OR):1.09; 95％ CI:0.63-1.87],whereas the 10-d LA regimen was significantly more effective than QT (OR:5.05; 95％ CI:2.74-9.31; P ＜ 0.001;I2 =75％).No differences were reported in QT eradication rates among Asian and European studies,whereas LA regimens were more effective in European populations (78.3％ vs 67.7％; P =0.05).Incidence of SE was lower in LA therapy than QT (OR:0.39; 95％ CI:0.18-0.85; P =0.02).A higher rate of side effects was reported in Asian patients who received QT.Our findings support the use of 10-d LA as a simple second-line treatment for H.pylori eradication with an excellent eradication rate and tolerability.The optimal second-line alternative scheme might differ among countries depending on quinolone resistance.

Helicobacter pyloriSecond-line treatmentLevofloxacinQuadruple regimen

Simona Di Caro、Lucia Fini、Yayha Daoud、Fabio Grizzi、Antonio Gasbarrini、Antonino De Lorenzo、Laura Di Renzo

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Department of Gastroenterology, University College Hospital, London NW1 2PG, United Kingdom

Division of Human Nutrition, University of Tor Vergata, 00173 Rome, Italy

Department of Gastroenterology and Laboratory of Molecular Gastroenterology, Humanitas Clinical and Research Center, Rozzano, 20089 Milan, Italy

Baylor Health Care System, Institute for Health Care Research and Improvement, Dallas,TX 75246, United States

Department of Internal Medicine, Gemelli Hospital, Catholic University of Rome, 00168 Rome, Italy

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2012

10.3748/wjg.v18.i40.5669

世界胃肠病学杂志(英文版)
太原消化病研治中心

世界胃肠病学杂志(英文版)

SCI
影响因子：1.001
ISSN：1007-9327
年,卷(期)：2012.18(40)
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