Source: Spine  |  Posted 8 years ago

Levofloxacin-based triple therapy appears to be a safe and effective second-line treatment for the eradication of []Helicobacter pylori[] after failure of standard lansoprazole-amoxicillin-clarithromycin therapy, according to a preliminary Japanese study.

Standard first-line treatments for the eradication of []H. pylori[] infection tend to fail in about 20% of patients. Choosing the best therapeutic option for successful eradication after initial treatment failure can be difficult.

Levofloxacin is a fluoroquinolone that has shown []in vitro[] activity against both Gram-negative and Gram-positive microorganisms. The use of levofloxacin in first line therapy has been studied; however, its potential as a second-line option has not been investigated.

Researchers at the Kobe University School of Medicine, Kobe, Japan, evaluated the efficacy and tolerability of a levofloxacin-based triple therapy as a second-line approach to eradication of []H. pylori[].

The prospective, uncontrolled study included 33 patients in whom standard triple therapy (lansoprazole-amoxicillin-clarithromycin) failed to eradicate []H. pylori[] infection after 1 week of treatment. Patients were retreated with lansoprazole (30 mg twice daily), amoxicillin (1000 mg twice daily), and levofloxacin (200 mg twice daily) for 1 week.

The infection was considered to be cured if negative results were obtained from culture, histology and a urea breath test 4 to 8 weeks after second-line therapy.

Overall, 69.7% of patients achieved successful eradication of []H. pylori[] 4 to 8 weeks after levofloxacin-based treatment. Notably, a similar eradication rate was seen in both intent-to-treat and per-protocol analyses.

Mild side effects were reported by 7 patients, or 21.2%. These reports included soft stools and taste disturbance. Importantly, no patients discontinued treatment due to adverse events.

These findings suggest the efficacy levofloxacin-based triple therapy as a second-line treatment for eradication of []H. pylori[] infection after failure of standard first-line therapy.