Curative Effect of Levofloxacin-based Triple Therapy as Rescue Regimen for <i>Helicobacter pylori</i>: A Meta-analysis_West China Medical Journal

Authors：

 LüBi-hua ¹ , ZHUHui ¹ , ZENGJing ²

1. Department of Pharmacy, Zhongnan Hospital of Wuhan University, Wuhan, Hubei 430071, P. R. China;
2. School of Public Health, Wuhan University of Science and Technology, Wuhan, Hubei 430065, P. R. China;

Corresponding?author：

Keywords：

Helicobacter pylori; Levofloxacin; Quadruple therapy; Meta-analysis

DOI：

10.7507/1002-0179.20150126

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To evaluate the effectiveness and side-effects of levofloxacin-based triple therapy as rescue regimen for Helicobacter pylori, and to compare it with the quadruple therapy. Methods Science Direct, PubMed, Medline, China National Knowledge Infrastructure (CNKI), Chinese Social Sciences Citation Index (CSSCI, developed by Chongqing VIP Company), and Wanfang Database were electronically searched from January 2000 to September 2013. Randomized controlled trials (RCT) were focused on the eradication rate and adverse effects of levofloxacin-based regimens and generally recommended quadruple therapy after failure to eradicate Helicobacter pylori for one or more times. Two reviewers independently screened studies according to exclusion and inclusion criteria, extracted data, and assessed the methodological quality. Then, meta-analysis was performed using RevMan 5.0 software. Results Fourteen literatures involving 1 402 patients were included. Meta-analysis showed that the levofloxacin-based group was better than the quadruple therapy group [RR=1.16, 95%CI (1.04, 1.30), P=0.009]. In addition, the adverse effects of levofloxacin group was less than the quadruple therapy group[OR=0.44, 95%CI (0.24, 0.81), P=0.008]. Conclusion After the failure of eradication of Helicobacter pylori, levofloxacin-based rescue regimen is more effective and better tolerated than the generally recommended quadruple therapy.

Citation： LüBi-hua, ZHUHui, ZENGJing. Curative Effect of Levofloxacin-based Triple Therapy as Rescue Regimen for Helicobacter pylori: A Meta-analysis. West China Medical Journal, 2015, 30(3): 432-437. doi: 10.7507/1002-0179.20150126 Copy

1.	蘇秉忠. 合理用藥提高幽門螺桿菌根除率[J]. 內蒙古醫學雜志, 2007, 39(1):1-3.
2.	Croom KF, Goa KL. Levofloxacin:a review of its use in the treatment of bacterial infections in the United States[J]. Drugs, 2003, 63(24):2769-2802.
3.	丁祿榮, 莊彥華, 艾江, 等. 補救治療根除幽門螺桿菌失敗病例的臨床觀察[J]. 牡丹江醫學院學報, 2008, 29(3):52-53.
4.	馬春曦, 彭國林, 張曉云. 新三聯方案根除幽門螺桿菌的療效觀察[J]. 東南國防醫藥, 2008, 10(3):192-194.
5.	周穎, 陸思源. 左氧氟沙星三聯療法根除幽門螺桿菌臨床觀察[J]. 中華現代內科學雜志, 2008, 5(1):531-532.
6.	張昊, 于靜, 賈長河. 用三聯法根除幽門螺桿菌失敗后的補救方案[J]. 中國臨床藥理學雜志, 2008, 24(4):361-363.
7.	粱志根. 全華斌, 何善智. 左氧氟沙星、阿莫西林、埃索美拉唑三聯療法在幽門螺桿菌補救治療的臨床研究[J]. 海南醫學, 2007, 18(7):1-3.
8.	杜勇, 宋軍, 盧光新, 等. 不同治療方案在幽門螺旋桿菌復治失敗后的應用比較[J]. 實用醫學雜志, 2006, 22(5):574-575.
9.	段雪輝, 尹合坤. 含左氧氟沙星三聯療法根除幽門螺桿菌的臨床研究[J]. 實用臨床醫藥雜志, 2012, 16(5):69-71.
10.	高元平, 郝衛剛, 張延濤. 含鉍劑及左氧氟沙星四聯療法根除幽門螺桿菌療效分析[J]. 現代醫藥衛生, 2011, 27(21):3234-3236.
11.	陳建兒, 郭淦華, 沈建沖, 等. 含左氧氟沙星序貫療法對幽門螺桿菌感染補救治療的療效分析[J]. 中國現代醫生, 2010, 48(30):114-116.
12.	Nista E, Candelli M. Levofloxacin-based triple therapy in first-line treatment for Helicobacter pylori eradication:update[J]. Gastroenterology, 2005, 101(9):1985-1989.
13.	Bilardi C, Dulbecco P, Zentilin PA, et al. A 10-Day levofloxacin-based therapy in patients with resistant Helicobacter pylori infection:a controlled trial[J]. Clin Gastroenterol Hepatol, 2004, 2(11):997-1002.
14.	Nista EC, Candelli M, Cremonini F, et al. Levofloxacin-based triple therapy vs. quadruple therapy in second-line Helicobacter pylori treatment:a randomized trial[J]. Aliment Pharmacol Ther, 2003, 18(6):627-633.
15.	Wong WM, Gu Q, Lam SK, et al. Randomized controlled study of rabeprazole, levofloxacin and rifabutin triple therapy vs. quadruple therapy as second-line treatment for Helicobacter pylori infection[J]. Aliment Pharmacol Ther, 2003, 17(4):553-560.
16.	Moon JY, Kim GH, You HS, et al. Levofloxacin, metronidazole, and lansoprazole triple therapy compared to quadruple therapy as a second-line treatment of Helicobacter pylori infection in Korea[J]. Gut Liver, 2013, 7(4):406-410.
17.	Xia H, Wong B, Lam SK. Helicobacter pylori infection and gastric cancer[J]. Asian J Surg, 2001, 24(3):217-222.
18.	Wong, Shiu KL, Wai M, et al. Helicobacter pylori eradication to prevent gastric cancer in a high region of China[J]. JAMA, 2004, 291(2):187-194.
19.	楊憲武, 趙逵, 張曉博. 根除幽門螺桿菌失敗33例相關因素分析[J]. 華西醫學, 2010,25(5):837-839.
20.	王登映. 根除幽門螺桿菌與治療糖尿病性胃輕癱的療效分析[J]. 華西醫學, 2010, 25(2):253-254.
21.	靳紅, 斯錁. 根除幽門螺桿菌對糖尿病胃輕癱的治療作用研究[J]. 華西醫學, 2011, 26(2):189-191.
22.	華影, 董衛國, 呂曉光. 幽門螺旋桿菌陽性患者首次根除治療失敗后二線治療方案的循證醫學證據[J]. 中國循證醫學雜志, 2011, 11(4):473-476.
23.	程君, 王迎迎, 李慧, 等. 合肥市產超廣譜β-內酰胺酶菌株的SHV型耐藥基因分布和耐藥性分析[J]. 中國藥理學通報, 2007, 23(6):812-815.
24.	秦秀蘭, 溫悅, 孟德勝. 某綜合性三級甲等醫院門/急診質子泵抑制劑合并用藥情況分析[J]. 中國藥房, 2010(46):4340-4342.
25.	錢韶紅, 韋曉靜, 王麗. 四聯療法聯合丹參根除幽門螺桿菌的臨床治療[J]. 中國醫院藥學雜志, 2012, 32(15):1230-1232.
26.	張慶, 胡承明, 譚小平, 等. 含呋喃唑酮三聯方案不同療程治療幽門螺桿菌的療效觀察[J]. 中國醫院藥學雜志, 2011(21):1799-1802.
27.	Gisbert JP, Pajares JM. Review article:Helicobacter pylori "rescue" regimen when proton pump inhibitor-based triple therapies fail[J]. Aliment Pharmacol Ther, 2002, 16(6):1047-1057.

1. 蘇秉忠. 合理用藥提高幽門螺桿菌根除率[J]. 內蒙古醫學雜志, 2007, 39(1):1-3.
2. Croom KF, Goa KL. Levofloxacin:a review of its use in the treatment of bacterial infections in the United States[J]. Drugs, 2003, 63(24):2769-2802.
3. 丁祿榮, 莊彥華, 艾江, 等. 補救治療根除幽門螺桿菌失敗病例的臨床觀察[J]. 牡丹江醫學院學報, 2008, 29(3):52-53.
4. 馬春曦, 彭國林, 張曉云. 新三聯方案根除幽門螺桿菌的療效觀察[J]. 東南國防醫藥, 2008, 10(3):192-194.
5. 周穎, 陸思源. 左氧氟沙星三聯療法根除幽門螺桿菌臨床觀察[J]. 中華現代內科學雜志, 2008, 5(1):531-532.
6. 張昊, 于靜, 賈長河. 用三聯法根除幽門螺桿菌失敗后的補救方案[J]. 中國臨床藥理學雜志, 2008, 24(4):361-363.
7. 粱志根. 全華斌, 何善智. 左氧氟沙星、阿莫西林、埃索美拉唑三聯療法在幽門螺桿菌補救治療的臨床研究[J]. 海南醫學, 2007, 18(7):1-3.
8. 杜勇, 宋軍, 盧光新, 等. 不同治療方案在幽門螺旋桿菌復治失敗后的應用比較[J]. 實用醫學雜志, 2006, 22(5):574-575.
9. 段雪輝, 尹合坤. 含左氧氟沙星三聯療法根除幽門螺桿菌的臨床研究[J]. 實用臨床醫藥雜志, 2012, 16(5):69-71.
10. 高元平, 郝衛剛, 張延濤. 含鉍劑及左氧氟沙星四聯療法根除幽門螺桿菌療效分析[J]. 現代醫藥衛生, 2011, 27(21):3234-3236.
11. 陳建兒, 郭淦華, 沈建沖, 等. 含左氧氟沙星序貫療法對幽門螺桿菌感染補救治療的療效分析[J]. 中國現代醫生, 2010, 48(30):114-116.
12. Nista E, Candelli M. Levofloxacin-based triple therapy in first-line treatment for Helicobacter pylori eradication:update[J]. Gastroenterology, 2005, 101(9):1985-1989.
13. Bilardi C, Dulbecco P, Zentilin PA, et al. A 10-Day levofloxacin-based therapy in patients with resistant Helicobacter pylori infection:a controlled trial[J]. Clin Gastroenterol Hepatol, 2004, 2(11):997-1002.
14. Nista EC, Candelli M, Cremonini F, et al. Levofloxacin-based triple therapy vs. quadruple therapy in second-line Helicobacter pylori treatment:a randomized trial[J]. Aliment Pharmacol Ther, 2003, 18(6):627-633.
15. Wong WM, Gu Q, Lam SK, et al. Randomized controlled study of rabeprazole, levofloxacin and rifabutin triple therapy vs. quadruple therapy as second-line treatment for Helicobacter pylori infection[J]. Aliment Pharmacol Ther, 2003, 17(4):553-560.
16. Moon JY, Kim GH, You HS, et al. Levofloxacin, metronidazole, and lansoprazole triple therapy compared to quadruple therapy as a second-line treatment of Helicobacter pylori infection in Korea[J]. Gut Liver, 2013, 7(4):406-410.
17. Xia H, Wong B, Lam SK. Helicobacter pylori infection and gastric cancer[J]. Asian J Surg, 2001, 24(3):217-222.
18. Wong, Shiu KL, Wai M, et al. Helicobacter pylori eradication to prevent gastric cancer in a high region of China[J]. JAMA, 2004, 291(2):187-194.
19. 楊憲武, 趙逵, 張曉博. 根除幽門螺桿菌失敗33例相關因素分析[J]. 華西醫學, 2010,25(5):837-839.
20. 王登映. 根除幽門螺桿菌與治療糖尿病性胃輕癱的療效分析[J]. 華西醫學, 2010, 25(2):253-254.
21. 靳紅, 斯錁. 根除幽門螺桿菌對糖尿病胃輕癱的治療作用研究[J]. 華西醫學, 2011, 26(2):189-191.
22. 華影, 董衛國, 呂曉光. 幽門螺旋桿菌陽性患者首次根除治療失敗后二線治療方案的循證醫學證據[J]. 中國循證醫學雜志, 2011, 11(4):473-476.
23. 程君, 王迎迎, 李慧, 等. 合肥市產超廣譜β-內酰胺酶菌株的SHV型耐藥基因分布和耐藥性分析[J]. 中國藥理學通報, 2007, 23(6):812-815.
24. 秦秀蘭, 溫悅, 孟德勝. 某綜合性三級甲等醫院門/急診質子泵抑制劑合并用藥情況分析[J]. 中國藥房, 2010(46):4340-4342.
25. 錢韶紅, 韋曉靜, 王麗. 四聯療法聯合丹參根除幽門螺桿菌的臨床治療[J]. 中國醫院藥學雜志, 2012, 32(15):1230-1232.
26. 張慶, 胡承明, 譚小平, 等. 含呋喃唑酮三聯方案不同療程治療幽門螺桿菌的療效觀察[J]. 中國醫院藥學雜志, 2011(21):1799-1802.
27. Gisbert JP, Pajares JM. Review article:Helicobacter pylori "rescue" regimen when proton pump inhibitor-based triple therapies fail[J]. Aliment Pharmacol Ther, 2002, 16(6):1047-1057.

West China Medical Journal

Curative Effect of Levofloxacin-based Triple Therapy as Rescue Regimen for Helicobacter pylori: A Meta-analysis

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content