https://scholars.lib.ntu.edu.tw/handle/123456789/541058
標題: | Levofloxacin-based and clarithromycin-based triple therapies as first-line and second-line treatments for Helicobacter pylori infection: A randomised comparative trial with crossover design | 作者: | JYH-MING LIOU Lin J.-T. Chang C.-Y. MEI-JYH CHEN TSU-YAO CHENG YI-CHIA LEE CHIEN-CHUAN CHEN WANG-HUEI SHENG HSIU-PO WANG MING-SHIANG WU |
公開日期: | 2010 | 卷: | 59 | 期: | 5 | 起(迄)頁: | 572-578 | 來源出版物: | Gut | 摘要: | Background: The efficacy of a levofloxacin-based regimen as the first-line treatment and a clarithromycin-based regimen as the second-line treatment for Helicobacter pylori infection remains unknown. The aim of this study was to assess the eradication rates of these two regimens using different administration sequences. Methods: Eligible patients were randomised to receive LAL: levofloxacin (750 mg once a day), amoxicillin (1000 mg twice a day) and lansoprazole (30 mg twice a day) for 7 days, or CAL: clarithromycin (500 mg twice a day), amoxicillin (1000 mg twice a day) and lansoprazole (30 mg twice a day) for 7 days. Patients with positive [13C]urea breath test after treatment were retreated with the rescue regimen in a crossover manner for 10 days. Result: 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 perprotocol (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. Clinical trial number: NCT00816140. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-77951743890&doi=10.1136%2fgut.2009.198309&partnerID=40&md5=dc87a1a9c0daf8f1a4146159bdc333e6 https://scholars.lib.ntu.edu.tw/handle/123456789/541058 |
ISSN: | 0017-5749 | DOI: | 10.1136/gut.2009.198309 | SDG/關鍵字: | amoxicillin; carbon 13; clarithromycin; lansoprazole; levofloxacin; abdominal pain; adult; antibiotic sensitivity; article; bacterium culture; bacterium identification; bloating; clinical protocol; clinical trial; comparative study; constipation; controlled clinical trial; controlled study; crossover procedure; diarrhea; dizziness; drug efficacy; eradication therapy; female; headache; Helicobacter infection; Helicobacter pylori; human; infection resistance; major clinical study; male; multicenter study; myalgia; nausea; patient compliance; priority journal; randomized controlled trial; rash; retreatment; stomach biopsy; Taiwan; taste disorder; treatment duration; treatment outcome; urea breath test; vomiting; Adult; Anti-Bacterial Agents; Clarithromycin; Cross-Over Studies; Drug Administration Schedule; Drug Resistance, Bacterial; Drug Therapy, Combination; Female; Helicobacter Infections; Helicobacter pylori; Humans; Male; Microbial Sensitivity Tests; Middle Aged; Ofloxacin; Treatment Outcome; Young Adult |
顯示於: | 醫學系 |
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