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Dig Liver Dis. 2005 Nov;37(11):821-5. Epub 2005 Jul 22.

Levofloxacin- versus metronidazole-based rescue therapy for H. pylori infection in Japan.

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1
Division of Diabetes, Digestive and Kidney Diseases, Department of Clinical Molecular Medicine, Kobe University Graduate School of Medicine, Kobe, Japan.

Abstract

BACKGROUND:

The ideal second-line treatment regimens for Helicobacter pylori infection may differ between the areas, countries and races.

AIM:

The aim was to confirm which was the better regimen for second-line therapy after treatment failure with a standard triple therapy in Japan, a high dosage of levofloxacin- or metronidazole-based therapy.

PATIENTS:

Sixty outpatients with persistent H. pylori infection after a standard triple therapy were enrolled in this prospective, open-label and randomised trial.

METHODS:

The subjects were randomly administered levofloxacin (300 mg b.d.)- or metronidazole (500 mg b.d.)-based therapy with lansoprazole (30 mg b.d.) and amoxicillin (1000 mg b.d.) for 7 days, and the cure rates and side effects were analysed. Antimicrobial susceptibility was also examined before second-line therapy using the E-test.

RESULTS:

Good compliance was obtained without severe side effects in both the groups except for two patients. The cure rates, expressed as intention-to-treat and per-protocol analyses, respectively, were 70.0 and 72.4% in the levofloxacin group, and 96.7 and 100% in the metronidazole group. Each regimen often overcame even clarithromycin-resistant strains.

CONCLUSION:

Metronidazole-based triple therapy is recommended as second-line therapy in Japan, and levofloxacin-based therapy can be an alternative treatment option.

PMID:
16040284
DOI:
10.1016/j.dld.2005.06.002
[Indexed for MEDLINE]
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