Levofloxacin-Azithromycin Combined Triple Therapy for Helicobacter pylori Eradication.
- Author:
Mun Su KANG
1
;
Dong Il PARK
;
Jung Won YUN
;
Se Yong OH
;
Tae Woo YOO
;
Jung Ho PARK
;
Hong Joo KIM
;
Yong Kyun CHO
;
Chong Il SOHN
;
Woo Kyu JEON
;
Byung Ik KIM
Author Information
1. Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea. diksmc.park@samsung.com
- Publication Type:Original Article ; English Abstract ; Randomized Controlled Trial
- Keywords:
Helicobacter pylori;
Levofloxacin;
Azithromycin
- MeSH:
Adult;
Anti-Bacterial Agents/*administration & dosage;
Azithromycin/*administration & dosage;
Drug Therapy, Combination;
Female;
Helicobacter Infections/*drug therapy/microbiology;
*Helicobacter pylori;
Humans;
Male;
Middle Aged;
Ofloxacin/*administration & dosage
- From:The Korean Journal of Gastroenterology
2006;47(1):30-36
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND/AIMS: Antibiotic resistance and poor compliance are the main causes of Helicobacter pylori (H. pylori) eradication failure. This study evaluated the eradication rate, tolerability, and compliance of levofloxacin- azithromycin combined triple therapy for H. pylori eradication. METHODS: 1) First-line eradication: A total of 78 H. pylori-positive patients were enrolled. Seventeen military men in Armed Forces Capital Hospital were treated with 7 days of levofloxacin-azithromycin combined triple therapy (omeprazole 20 mg bid, levofloxacin 500 mg od, and azithromycin 500 mg od), and 61 patients in Kangbuk Samsung Hospital were treated with standard PPI-based triple therapy (omeprazole 20 mg bid, amoxicillin 1.0 g bid, and clarithromycin 500 mg bid) for 7 days. 2) Second-line eradication: A consecutive series of 59 patients who failed H. pylori eradication with standard PPI-based triple therapy in Kangbuk Samsung Hospital were randomized to two groups. Thirty patients were retreated with 7 days of bismuth-based quadruple therapy (omeprazole 20 mg bid, bismuth 120 mg qid, metronidazole 500 mg tid, and tetracycline 500 mg qid), and remaining 29 patients were retreated with levofloxacin-azithromycin combined triple therapy. Patient's compliance and tolerability were evaluated at the end of treatment. The status of H. pylori infection was assessed 8 weeks later then. The successful eradication of H. pylori was defined as negative results from histology and CLO test, or 13C-urea breath test. RESULTS: First-line eradication rate of levofloxacin-azithromycin triple therapy was lower than that of standard PPI-based triple therapy, but there was no statistically significant difference (70.6% vs. 80.3%, p=0.390). Second-line eradication rate of levofloxacin-azithromycin combined triple therapy was significantly lower than that of bismuth-based quadruple therapy (ITT/PP 65.5%/73.1% vs. 90%/90%, p<0.0001). The compliances of all patients were more than 85%. Two of patients with levofloxacin-azithromycin combined triple therapy complained self-limiting side effects (mild dizziness; mild insomnia with general weakness). CONCLUSIONS: Levofloxacin-azithromycin combined triple therapy should not be recommended as the first-line or second-line H. pylori eradication regimen in Korea.
