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Title: Levofloxacin May Be Effective Option in Second Line Treatment of Helicobacter pylori Infection

URL: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=R
Retrieve&db=PubMed&dopt=Abstract&list_uids=14620620

Dig Liver Dis 2003 Oct;35:10:711-5. "Levofloxacin based triple therapy as a second-line treatment after failure of helicobacter pylori eradication with standard triple therapy"
12/05/2003 08:45:00 AM
By Deanna M Green, PhD

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.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=R
Retrieve&db=PubMed&dopt=Abstract&list_uids=14620620

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