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Dig Liver Dis. 2010 Aug;42(8):541-3. doi: 10.1016/j.dld.2009.12.007. Epub 2010 Jan 12.

Efficacy of H. pylori eradication with a sequential regimen followed by rescue therapy in clinical practice.

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1
Department of Surgery Sciences, "Sapienza" University, Rome, Italy. stefano.pontone@uniroma1.it

Abstract

BACKGROUND:

Current Italian guidelines suggest sequential therapy as first-line therapy and a levofloxacin-based rescue therapy for Helicobacter pylori eradication. We evaluated the efficacy of these therapies in clinical practice.

METHODS:

84 consecutive patients with dyspeptic symptoms and proven H. pylori infection by either UBT or upper endoscopy with biopsies were enrolled. Patients received a 10-day sequential therapy with lansoprazole 30mg plus amoxycillin 1g (all twice daily) for the first 5 days, followed by lansoprazole 30mg, clarithromycin 500mg, and metronidazole 500mg (all twice daily) for the remaining 5 days. Eradication failure patients received triple therapy with lansoprazole 30mg, levofloxacin 250mg, and amoxycillin 1g (all twice daily) for 10 days.

RESULTS:

Following the sequential therapy H. pylori eradication was achieved in 70/84 (83.3%; 95% CI=75.4-91.3) patients, and in 70/77 (90.9%; 95% CI=84.5-97.3) patients at ITT and PP analyses, respectively. The infection was cured in all 7 eradication failure patients by using second-line therapy.

CONCLUSIONS:

A sequential regimen as first-line therapy and a 10-day levofloxacin-based triple regimen in those patients who failed to clear the infection, appear to be a valid therapeutic strategy for management of H. pylori infection in clinical practice.

PMID:
20061196
DOI:
10.1016/j.dld.2009.12.007
[Indexed for MEDLINE]
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