Helikobakter pilori tedavisinde levofloksasin tabanlý rejimler baþarýlýmýdýr?
Levofloksasin 750 mg gün + amoksisilin 2x1 gr gün+ lansaprazol 30 mg 2x1 7 günlük tedaviler klaritromisin tabanlý 3 lü tedavi ile bir haftalýk tedavilerde karþýlaþtýrýlmýþtýr. (gut 2010)
sonuçta ilk basamak tedavide hala klaritromisin tabanlý tedavi daha baþarýlý iken ikinci basamak tedavide levofloksasin tabanlý tedavi oldukça baþarýlýdýr.
aþaðýda oroijinal abstractaki veriler görülmektedir.
conclusion:
When used as first-line treatment (n=432), the eradication rates of LAL (n=217) and CAL (n=215) were 74.2 and 83.7% (p=0.015) in the intent-to-treat (ITT) analysis, and 80.1 and 87.4% (p=0.046) in the per-protocol (PP) analysis, respectively. When used as second-line treatment, the eradication rates of LAL (n=26) and CAL (n=40) were 76.9 and 60% (p=0.154) in the ITT analysis, and 80 and 61.5% (p=0.120) in the PP analysis, respectively. The overall eradication rates of CAL followed by LAL were better than the reverse sequence in both the ITT analysis (93% vs 85.3%, p=0.01) and the PP analysis (97.6% vs 92.5%, p=0.019). The eradication rate was significantly lower in the presence of levofloxacin resistance in the LAL group (50% vs 84.4%, p=0.018) and clarithromycin resistance in the CAL group (44.4% vs 90.7%, p=0.002). CONCLUSION: CAL achieved a higher eradication rate than LAL as the first-line treatment, but not as the second-line treatment. The strategy of using CAL as the initial treatment and LAL as the rescue regimen achieved higher eradication rates than the reverse sequence. öte yandan baþka bir yayýnda
2010 yýlý baþka bir yayýnda ise levofloksasin tabanlý 3 tedavi 1 haftalýk sürelerde klairtromisin tabanlý tedavi ile karþýlaþtýrýldýðýnda oran olarak daha baþarýlý bulunmuþtur. her ne kadar istatistiksel olarak anlamlý bir yükseklik vermedi isede yazarlar levoflokasasin tabanlý rejimin 1 basamak olarak kullanýlabileceðini söylemektedirler.
Zhonghua Yi Xue Za Zhi. 2010 Jan 12;90(2):79-82.
[Levofloxacin-based triple therapy for first-line Helicobacter pylori eradication treatment: a multi-central, randomized, controlled clinical study]
[Article in Chinese]
Cheng H, et al
Department of Gastroenterology, First Hospital, Peking University, Beijing 100034, China.
Abstract
OBJECTIVE: To compare efficacy and tolerability of 7-day standard triple therapy versus 7-day levofloxacin-based triple therapy in first-line treatment for Helicobacter pylori (H. pylori) infection. METHODS: Three hundred consecutive H.pylori positive patients were randomized to receive: clarithromycin, amoxicillin, lansoprazole (Group A: n = 150); or amoxicillin, levofloxacin, lansoprazole (Group B: n = 150). H. pylori status was rechecked by (13)C-urea breath test 4 weeks after the end of therapy. RESULTS: The eradication rates in intention to treat (ITT) and per protocol (PP) analyses were: Group A, 74.5% (111/149) and 78.2% (111/142); and Group B, 82.4% (122/148) and 83.0%(122/147). Although the eradication rate achieved with levofloxacin-based triple therapy was higher than that with standard therapies in either ITT or PP analysis, but no significantly difference was found between the two triple therapies. The incidence of side effects was similar among groups. CONCLUSIONS: A 7-day levofloxacin-based triple therapy can achieve higher H.pylori eradication rate than standard regimen. The levofloxacin-based regimen can be one effective therapy for the first-line anti-H.pylori treatment.
