Effect of fluoroquinolone resistance on 14-day levofloxacin triple and triple plus bismuth quadruple therapy.
Effect of fluoroquinolone resistance on 14-day levofloxacin triple and triple plus bismuth quadruple therapy.
复制标题
氟喹诺酮耐药性对14天左氧氟沙星三倍和三重加苯甲酸四核治疗的影响。
作者：
Liao J;Zheng Q;Liang X;Zhang W;Sun Q;Liu W;Xiao S;Graham DY;Lu H
左氧氟沙星已被建议代替克拉霉素治疗幽门螺杆菌。7天和10天的氟喹诺酮三联治疗通常无法达到≥90%的治愈率，而14天的治疗成功率为95%。目的是评估加铋或不加铋的含左氧氟沙星三联治疗14天氟喹诺酮类药物耐药的疗效和影响。幽门螺杆菌阳性的功能性消化不良或愈合的消化性溃疡患者随机接受兰索拉唑30 mg /天，阿莫西林1000 mg /天，左氧氟沙星500 mg /天，联合（B-LAL）或不联合（LAL）枸橼酸铋钾220 mg /天，持续14天。治疗结束4周后通过13c -尿素呼气试验评估根除情况。采用琼脂稀释法进行药敏试验。成功定义为PP成功率≥90%。入组的161名患者（81名LAL和80名B-LAL）中有152名完成了治疗。B-LAL的PP率为94.6% (70/74;95% CI, 86.9-97.9%)， LAL的PP率为85.9% (95% CI, 76.5-91.9%) (p = 0.07)；B-LAL组ITT根除率为87.5% (95% CI, 78.5 ~ 93.1%)， LAL组为82.7% (95% CI, 73 ~ 89.4%) （p = 0.39）。左氧氟沙星耐药占30.3%。B-LAL的敏感菌株（97.5%）对耐药菌株（70.6%）和LAL的97.3%对37.5%的治疗成功率非常好。当氟喹诺酮类药物耐药率<12%时，14天氟喹诺酮类药物治疗最有效。在氟喹诺酮类药物耐药性高达25%的情况下，添加铋保持有效性。
Levofloxacin has been proposed to replace clarithromycin for Helicobacter pylori treatment. Seven- and 10-day fluoroquinolone triple therapies have generally failed to achieve cure rates of ≥90%, whereas 14-day therapy has achieved 95% success. The aim was to assess the efficacy and effect of fluoroquinolone resistance on 14-day levofloxacin-containing triple therapy with or without the addition of bismuth. Helicobacter pylori-positive patients with functional dyspepsia or healed peptic ulcers were randomized to receive lansoprazole 30 mg b.i.d., amoxicillin 1000 mg b.i.d., and levofloxacin 500 mg daily with (B-LAL) or without (LAL) bismuth potassium citrate 220 mg b.i.d. for 14 days. Eradication was assessed by 13C-urea breath testing 4 weeks after completing treatment. Antimicrobial susceptibility was by the agar dilution method. Success was defined as PP success ≥90%. A total of 152 of 161 patients (81 LAL and 80 B-LAL) enrolled completed treatment. The PP rates were 94.6% (70/74; 95% CI, 86.9–97.9%) with B-LAL and 85.9% (95% CI, 76.5–91.9%) with LAL (p = .07); the ITT eradication rates were 87.5% (95% CI, 78.5–93.1%) with B-LAL and 82.7% (95% CI, 73–89.4%) with LAL (p = .39). Levofloxacin resistance was present in 30.3%. Treatment success was excellent with susceptible strains (97.5%) versus resistant strains (70.6%) for B-LAL and 97.3% versus 37.5% for LAL, respectively. Fourteen-day fluoroquinolone therapy was highly effective when fluoroquinolone resistance rates are <12%. The addition of bismuth maintained effectiveness with fluoroquinolone resistance as high as 25%.
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影响因子：
9.8
作者：
Saad, RJ;Schoenfeld, P;Chey, WD
通讯作者：
Chey, WD
DOI：
10.1097/00042737-200212000-00004
发表时间：
2002-12-01
影响因子：
2.1
作者：
Di Caro, S;Zocco, MA;Gasbarrini, A
通讯作者：
Gasbarrini, A
影响因子：
4.4
作者：
Miehlke, Stephan;Krasz, Susanne;Morgner, Andrea
通讯作者：
Morgner, Andrea
影响因子：
4.5
作者：
Watanabe, Y;Aoyama, N;Kasuga, M
通讯作者：
Kasuga, M
影响因子：
4.4
作者：
Hung, Kuei-Hsiang;Sheu, Bor-Shyang;Wu, Jiunn-Jong
通讯作者：
Wu, Jiunn-Jong