Levofloxacin, Metronidazole, and Lansoprazole Triple Therapy Compared to Quadruple Therapy as a Second-Line Treatment of Helicobacter pylori Infection in Korea
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Background/Aims: Several rescue therapies have been recommended to eradicate Helicobacter pylori infection in patients with a failure of first-line eradication therapy, but they still fail in more than 20% of cases. The aim of this study was to evaluate the efficacy and safety of levofloxacin, metronidazole,and lansoprazole (LML) triple therapy relative to quadruple therapy as a second-line treatment. Methods: In total,113 patients who failed first-line triple therapy for H. pylori infection were randomly assigned to two groups: LML for 7days and tetracycline, bismuth subcitrate, metronidazole and lansoprazole (quadruple) for 7 days. Results: According to intention-to-treat analysis, the infection was eradicated in 38of 56 patients (67.9%) in the LML group and 48 of 57 (84.2%)in the quadruple group (p=0.042). Per-protocol analysis showed successful eradication in 38 of 52 patients (73.1%)from the LML group and 48 of 52 (92.3%) from the quadruple group (p=0.010). There were no significant differences in the adverse effects in either treatment group. Conclusions:LML therapy is less effective than quadruple therapy as a second-line treatment for H. pylori infection. Therefore, quadruple therapy should be considered as the primary secondline strategy for patients experiencing a failure of first-line H. pylori therapy in Korea.
Abstract
Background/Aims: Several rescue therapies have been recommended to eradicate Helicobacter pylori infection in patients with a failure of first-line eradication therapy, but they still fail in more than 20% of cases. The aim of this study was to evaluate the efficacy and safety of levofloxacin, metronidazole,and lansoprazole (LML) triple therapy relative to quadruple therapy as a second-line treatment. Methods: In total,113 patients who failed first-line triple therapy for H. pylori infection were randomly assigned to two groups: LML for 7days and tetracycline, bismuth subcitrate, metronidazole and lansoprazole (quadruple) for 7 days. Results: According to intention-to-treat analysis, the infection was eradicated in 38of 56 patients (67.9%) in the LML group and 48 of 57 (84.2%)in the quadruple group (p=0.042). Per-protocol analysis showed successful eradication in 38 of 52 patients (73.1%)from the LML group and 48 of 52 (92.3%) from the quadruple group (p=0.010). There were no significant differences in the adverse effects in either treatment group. Conclusions:LML therapy is less effective than quadruple therapy as a second-line treatment for H. pylori infection. Therefore, quadruple therapy should be considered as the primary secondline strategy for patients experiencing a failure of first-line H. pylori therapy in Korea.
참고문헌 (29)
- Wong WM, "Lansoprazole, levofloxacin and amoxicillin triple therapy vs. quadruple therapy as second-line treatment of resistant Helicobacter pylori infection", Aliment Pharmacol Ther, 23, pp.421~427 (2006)
- Hopkins RJ, "Relationship between Helicobacter pylori eradication and reduced duodenal and gastric ulcer recurrence: a review", Gastroenterology, 110, pp.1244~1252 (1996)
- Zullo A, "Second-line and rescue therapies for Helicobacter pylori eradication in clinical practice", J Gastrointestin Liver Dis, 19, pp.131~134 (2010)
- Malfertheiner P, "Current concepts in the management of Helicobacter pylori infection: the Maastricht III Consensus Report", Gut, 56, pp.772~781 (2007)
- Fock KM, "Second Asia-Pacific Consensus Guidelines for Helicobacter pylori infection", J Gastroenterol Hepatol, 24, pp.1587~1600 (2009)
- Gisbert JP, "Proton pump inhibitor, clarithromycin and either amoxycillin or nitroimidazole: a meta-analysis of eradication of Helicobacter pylori", Aliment Pharmacol Ther, 14, pp.1319~1328 (2000)
- Fuccio L, "Meta-analysis: duration of first-line proton-pump inhibitor based triple therapy for Helicobacter pylori eradication", Ann Intern Med, 147, pp.553~562 (2007)
- 이지현, "Helicobacter pylori 제균치료에서 Levofloxacin 병합요법의 효과", 대한소화기학회지, 48(1), pp.19~24 (2006), 대한소화기학회
- Lamouliatte H, "Double vs. single dose of pantoprazole in combination with clarithromycin and amoxycillin for 7 days, in eradication of Helicobacter pylori in patients with non-ulcer dyspepsia", Aliment Pharmacol Ther, 13, pp.1523~1530 (1999)
- Wurzer H, "Short-course therapy with amoxycillin-clarithromycin triple therapy for 10 days (ACT-10) eradicates Helicobacter pylori and heals duodenal ulcer. ACT-10 Study Group", Aliment Pharmacol Ther, 11, pp.943~952 (1997)
- Lam SK, "Report of the 1997 Asia Pacific Consensus Conference on the management of Helicobacter pylori infection", J Gastroenterol Hepatol, 13, pp.1~12 (1998)
- Gisbert JP, "Review article: Helicobacter pylori “rescue” regimen when proton pump inhibitor-based triple therapies fail", Aliment Pharmacol Ther, 16, pp.1047~1057 (2002)
- 김승영, "국내 Helicobacter pylori 의 제균 치료", 대한소화기학회지, 58(2), pp.67~73 (2011), 대한소화기학회
- Gisbert JP, "Second-line rescue therapy of helicobacter pylori infection", Therap Adv Gastroenterol, 2, pp.331~356 (2009)
- Li Y, "Advantages of Moxifloxacin and Levofloxacin-based triple therapy for second-line treatments of persistent Helicobacter pylori infection: a meta analysis", Wien Klin Wochenschr, 122, pp.413~422 (2010)
- Watanabe Y, "Levofloxacin based triple therapy as a second-line treatment after failure of helicobacter pylori eradication with standard triple therapy", Dig Liver Dis, 35, pp.711~715 (2003)
- Di Caro S, "Levofloxacin based regimens for the eradication of Helicobacter pylori", Eur J Gastroenterol Hepatol, 14, pp.1309~1312 (2002)
- Gisbert JP, "Empirical rescue therapy after Helicobacter pylori treatment failure: a 10-year single-centre study of 500 patients", Aliment Pharmacol Ther, 27, pp.346~354 (2008)
- Bilardi C, "A 10-day levofloxacin-based therapy in patients with resistant Helicobacter pylori infection: a controlled trial", Clin Gastroenterol Hepatol, 2, pp.997~1002 (2004)
- Matsumoto Y, "Levofloxacin- versus metronidazole-based rescue therapy for H. pylori infection in Japan", Dig Liver Dis, 37, pp.821~825 (2005)
- Di Caro S, "Second-line levofloxacin-based triple schemes for Helicobacter pylori eradication", Dig Liver Dis, 41, pp.480~485 (2009)
- Gisbert JP, "Systematic review and meta-analysis: levofloxacin-based rescue regimens after Helicobacter pylori treatment failure", Aliment Pharmacol Ther, 23, pp.35~44 (2006)
- Kuo CH, "Efficacy of levofloxacin-based rescue therapy for Helicobacter pylori infection after standard triple therapy: a randomized controlled trial", J Antimicrob Chemother, 63, pp.1017~1024 (2009)
- Nista EC, "Levofloxacin-based triple therapy vs. quadruple therapy in second-line Helicobacter pylori treatment: a randomized trial", Aliment Pharmacol Ther, 18, pp.627~633 (2003)
- Kim N, "Institutional difference of antibiotic resistance of Helicobacter pylori strains in Korea", J Clin Gastroenterol, 40, pp.683~687 (2006)
- 김재연, "한국에서 지역에 따른 Helicobacter pylori 균주 내성", 대한소화기학회지, 57(4), pp.221~229 (2011), 대한소화기학회
- Gerrits MM, "Role of the rdxA and frxA genes in oxygen-dependent metronidazole resistance of Helicobacter pylori", J Med Microbiol, 53(Pt 11), pp.1123~1128 (2004)
- 김재연, "한국인의 위·십이지장 질환에 따른 Helicobacter pylori 균주의 일차 항생제 내성과 H. pylori 제균율", 대한소화기학회지, 58(2), pp.74~81 (2011), 대한소화기학회
- Saad RJ, "Levofloxacin-based triple therapy versus bismuth-based quadruple therapy for persistent Helicobacter pyori infection: a meta-analysis", Am J Gastroenterol, 101, pp.488~496 (2006)