A prospective evaluation of levofloxacin-based triple therapy for refractory Helicobacter pylori infection in Australia.
Background First-line Helicobacter pylori eradication failure is a common and challenging problem. Aim To assess the efficacy of salvage levofloxacin-based triple therapy in Australia. Methods Prospective patients referred after prior treatment failure(s) were prescribed esomeprazole 40 mg, amoxicil...
| Publicado en: | Internal Medicine Journal Vol. 47; no. 7; pp. 761 - 767 |
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| Autores principales: | , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Wiley-Blackwell
Jul2017
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=123911593&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 123911593 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 14440903 HYC jtl: Internal Medicine Journal issn: 14440903 maglogo: Y pubinfo: dt: Jul2017 vid: 47 iid: 7 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 123911593 123911593 123911593 10.1111/imj.13432 123911593 ppf: 761 ppct: 6 formats: tig: atl: A prospective evaluation of levofloxacin-based triple therapy for refractory Helicobacter pylori infection in Australia. aug: au: Katelaris, Peter H. Katelaris, Anthea L. affil: Gastroenterology Department, Concord Hospital, University of Sydney, Sydney New South Wales, Australia sug: subj: Helicobacter Infections Drug Therapy Ofloxacin Therapeutic Use Amoxicillin Therapeutic Use Esomeprazole Therapeutic Use Human Prospective Studies Australia Amoxicillin Administration and Dosage Esomeprazole Administration and Dosage Breath Tests Urea Analysis Female Middle Age Medication Compliance Ofloxacin Administration and Dosage Administration, Oral Drug Therapy, Combination Disease Eradication Middle Aged: 45-64 years Female ab: Background First-line Helicobacter pylori eradication failure is a common and challenging problem. Aim To assess the efficacy of salvage levofloxacin-based triple therapy in Australia. Methods Prospective patients referred after prior treatment failure(s) were prescribed esomeprazole 40 mg, amoxicillin 1 g and levofloxacin 500 mg each twice daily for 10 days. All patients received detailed written and verbal adherence support. Outcome assessment was by 13C-urea breath test and/or histology and urease test. Results In 150 consecutive, evaluable patients (66% female, mean age 54 ± 14 years; six smokers), the main indications for treatment were peptic ulcer disease (17%), increased gastric cancer risk (20%), symptoms (35%) and other risk reduction (28%). The median number of previous treatments was 2 (range 1-7). Eradication of H. pylori was achieved in 90% (intention to treat ( ITT)) and 91% (per-protocol ( PP)) of patients. The eradication rate did not differ according to the type or number of prior treatments: 93% when ≤2 ( n = 107) compared with 84% after three or more prior treatments ( n = 43; P = 0.13) or with age, ethnicity or indication for treatment but it was higher in females ( ITT 94 vs 82%, P = 0.04). Adherence was excellent (95%). No serious adverse effects were observed; mild adverse effects were reported in 11%. No primary levofloxacin resistance was observed in 20 concurrent cases. Conclusion The efficacy and safety of this levofloxacin-based triple therapy suggests it should be used as a salvage regimen in this region. Randomised comparative trials are unlikely to be done but these data compare favourably with local data for other salvage therapies. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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