Application of levofloxacine in the second phase of sequential therapy regimen for Helicobacter pylori eradication: is it a good choice?
Abstract
AIM: The aim of this study was to evaluate whether modified sequential therapy regimen that consists of an initial phase, including a PPI plus amoxicillin for 5 days followed by a PPI plus only levofloxacin instead of 2 antibiotics for the remaining 5 days increase the eradication rate via decreasing the number and doses of antibiotics, and increasing patient compliance.
METHODS: This study included 40 patients who were admitted to Gastroenterology Outpatient Clinic with H. pylori-positive non-ulcer dyspepsia. All patients received lansoprazole 30 mg BID plus amoxicillin 1,000 mg BID for the first five days followed by lansoprazole 30 mg BID plus levofloxacine 500 mg BID for the remaining five days. Eradication rates were calculated using both intention-to-treat (ITT) and per-protocol (PP) analysis.
RESULTS: In all, 40 patients (21 females, 19 males) were analyzed with ITT analysis and 38 patients completed the study. H.pylori eradication was achieved in 27 (67.5%) of the 40 patients included in the ITT analysis and in 27 (71%) of the 38 patients included in the PP analysis. Mild adverse effects were reported by 8 patients (8.4%). The most frequent side effects were nausea and a metallic taste in the mouth. Any adverse effect that might lead patients to take less than 80% of the prescribed drugs was not reported.
CONCLUSION: This levoflaxin-based sequential therapy regimen was not superior over standard sequential therapy regimen in the eradication of H.pylori. However, it…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 40 participants or records.
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