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Multi-center randomized controlled study to establish the standard third-line regimen for Helicobacter pylori eradication in Japan.
- Source :
-
Journal of gastroenterology [J Gastroenterol] 2013 Oct; Vol. 48 (10), pp. 1128-35. Date of Electronic Publication: 2013 Jan 11. - Publication Year :
- 2013
-
Abstract
- Backgrounds: The present study sought to establish a standard third-line eradication regimen for Helicobacter pylori in Japan.<br />Methods: Subjects were 204 patients with H. pylori infection in whom the standard Japanese first- and second-line eradication therapies had proven unsuccessful. Patients were randomly assigned to one of the following third-line eradication therapy groups: (1) LA group: lansoprazole (LPZ) 30 mg 4 times a day (qid) + amoxicillin (AMPC) 500 mg qid for two weeks; (2) LAL group: LPZ 30 mg twice a day (bid) + AMPC 750 mg bid + levofloxacin (LVFX) 300 mg bid for one week; (3) LAS group: LPZ 30 mg bid + AMPC 750 mg bid + sitafloxacin (STFX) 100 mg bid for one week. Patients for whom these therapies failed underwent a crossover fourth-line eradication regimen. Drug sensitivity was also tested for AMPC, clarithromycin (CAM), MNZ, LVFX, and STFX.<br />Results: Drug resistance rates prior to third-line eradication therapy were 86.4 % for CAM, 71.3 % for MNZ, 57.0 % for LVFX, 8.2 % for AMPC, and 7.7 % for STFX. Intention-to-treat analysis of third-line eradication therapy eradication rates showed a significantly higher rate in the LAS group (70.0 %) compared with the LA group (54.3 %; p < 0.05) and the LAL group (43.1 %; p < 0.001). The significantly lower rate in the LAL group than the LAS group was caused by bacterial resistance to LVFX.<br />Conclusions: The findings suggest that triple therapy with PPI, AMPC, and STFX for one week would be an effective standard third-line eradication regimen for H. pylori in Japan.
- Subjects :
- Aged
Amoxicillin administration & dosage
Drug Resistance
Drug Therapy, Combination
Female
Fluoroquinolones administration & dosage
Humans
Japan
Lansoprazole administration & dosage
Levofloxacin administration & dosage
Male
Middle Aged
Treatment Outcome
Amoxicillin therapeutic use
Anti-Ulcer Agents therapeutic use
Fluoroquinolones therapeutic use
Helicobacter Infections drug therapy
Helicobacter pylori drug effects
Lansoprazole therapeutic use
Levofloxacin therapeutic use
Subjects
Details
- Language :
- English
- ISSN :
- 1435-5922
- Volume :
- 48
- Issue :
- 10
- Database :
- MEDLINE
- Journal :
- Journal of gastroenterology
- Publication Type :
- Academic Journal
- Accession number :
- 23307042
- Full Text :
- https://doi.org/10.1007/s00535-012-0731-8