Levofloxacin based regimens for the eradication of Helicobacter pylori
Levofloxacin based regimens for the eradication of Helicobacter pylori
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DOI：
10.1097/00042737-200212000-00004
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发表时间：
2002-12-01
影响因子：
2.1
通讯作者：
Gasbarrini, A
中科院分区：
文献类型：
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作者：
Di Caro, S;Zocco, MA;Gasbarrini, A
背景：以雷贝拉唑/左氧氟沙星/阿莫西林或替硝唑为基础的7天治疗方案，根治率达90%以上。目的比较雷贝拉唑/左氧氟沙星三联疗法与雷贝拉唑/左氧氟沙星/阿莫西林三联疗法5、7、10天的疗效和耐受性。方法160例经C-13尿素呼气试验和组织学证实的幽门螺杆菌感染患者，纳入前瞻性开放研究。受试者被随机分为四组：(1)左氧氟沙星(500 mg o.d)，阿莫西林(1g b.d)。雷贝拉唑(20 mg o.d.)(2)左氧氟沙星500 mg o.d；雷贝拉唑(20 mg o.d.)5天；(3)左氧氟沙星500 mg o.d。雷贝拉唑(20 mg o.d.)(4)左氧氟沙星(500 mg o.d.)雷贝拉唑(20 mg o.d.)住了10天。治疗结束6周后，采用C-13-尿素呼气试验检测幽门螺杆菌感染情况。联合治疗方案的根治率与疗程无关(5天：20/40，50%；7天：28/40，70%；10天：26/40，65%)。以左氧氟沙星为基础的1周三联疗法的根治率显著高于任何二联疗法(36/40)。结论雷贝拉唑/左氧氟沙星双重根除方案简单，耐受性好，但与1周的雷贝拉唑/左氧氟沙星/阿莫西林三联疗法相比，其根治率并不理想。化疗方案越长，根治率越低。
Background A 7 day treatment scheme based on rabeprazole/levofloxacin/amoxycillin or tinidazole achieved an eradication rate over 90%. However, the combination of drugs and duration of treatment for the correct use of levofloxacin in the eradication of Helicaobacter pylori are still unclear.Objective To compare the efficacy and tolerability of rabeprazole/levofloxacin based dual therapies given for 5, 7 or 10 days with rabeprazole/levofloxacin/amoxycillin triple therapy for 7 days.Methods One hundred and sixty patients with H. pylori infection documented by the C-13-urea breath test and histology were included in this prospective, open label study. Subjects were randomized in four groups: (1) levofloxacin (500 mg o.d.), amoxycillin (1 g b.d.) and rabeprazole (20 mg o.d.) for 7 days; (2) levofloxacin (500 mg o.d.) and rabeprazole (20 mg o.d.) for 5 days; (3) levofloxacin (500 mg o.d.) and rabeprazole (20 mg o.d.) for 7 days; and (4) levofloxacin (500 mg o.d.) and rabeprazole (20 mg o.d.) for 10 days. Six weeks after the end of therapy H. pylori status was checked by using the C-13-urea breath test.Results All patients completed the therapeutic regimens. The eradication rate was not significantly modified by treatment duration in the dual therapy schemes (5 days: 20/40, 50%; 7 days: 28/40, 70%; 10 days: 26/40, 65%). The eradication rate of the 1 week levofloxacin based triple therapy was significantly higher than that observed using any dual therapies (36/40). No major adverse effects were observed.Conclusions A rabeprazole/levofloxacin dual eradication regimen is simple and well tolerated but does not achieve an acceptable eradication rate when compared to a 1 week rabeprazole/levofloxacin/amoxycillin triple therapy. The eradication rate did not increase with a longer regimen.