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

• Authors: Y Matsumoto, I Miki, N Aoyama, D Shirasaka, Y Watanabe, Y Morita, M Toyoda, T Mitani, H Miyachi, T Tamura, M Kasuga
• Journal: Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver (Dig Liver Dis) Vol. 37 Issue 11 Pg. 821-5 (Nov 2005) ISSN: 1590-8658 [Print] Netherlands
• PMID: 16040284 (Publication Type: Comparative Study, Journal Article, Randomized Controlled Trial)

Chemical References

• Anti-Bacterial Agents
• Metronidazole
• Levofloxacin
• Ofloxacin

Topics

• Adult
• Aged
• Anti-Bacterial Agents (therapeutic use)
• Drug Therapy, Combination
• Female
• Helicobacter Infections (drug therapy)
• Helicobacter pylori
• Humans
• Japan
• Levofloxacin
• Male
• Metronidazole (therapeutic use)
• Middle Aged
• Ofloxacin (therapeutic use)
• Prospective Studies