40 P Levofloxacin based triple therapy as second-line treatment for H. pylori infection after failure of standard triple therapy

Bismuth quadruple therapy (BQT) is an effective treatment for Helicobacter pylori infection. However, frequent dosing schedules of BQT regimen often compromise drug adherence and may affect treatment outcomes. This retrospective study aimed to investigate the efficacy of twice-daily BQT compared to that of four times a day therapy. From August 2018 to November 2020, adult patients who failed first-line standard triple therapy and underwent BQT were eligible. Patients were categorized into two groups according to dosing schedule: (i) the BQT group (n = 213) who received standard BQT administered four times a day; and (ii) the BQTb group (n = 141) who received proton pump inhibitor, bismuth 600 mg, metronidazole 500 mg, and tetracycline 1 g twice a day. The eradication rate did not differ between the BQT (92.5%) and the BQTb groups (90.1%) (p = 0.441). Adherence and adverse event rate were similar between the two groups. Multivariate analysis showed that current smoking was associated with eradication failure; however, dosing frequency was not associated with the efficacy of eradication therapy. This study suggested that twice a day BQT is as effective as four times a day therapy for second-line treatment of H. pylori infection.

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Impact of Age, Gender, and Addition of Probiotics on Treatment Success for Helicobacter pylori in Children

Global Pediatric Health ◽

10.1177/2333794x15607798 ◽

2015 ◽

Vol 2 ◽

pp. 2333794X1560779 ◽

Cited By ~ 4

Author(s):

Noam Weiner ◽

Ron Shaoul

Keyword(s):

Helicobacter Pylori ◽

Treatment Success ◽

Primary Objective ◽

Line Treatment ◽

Second Line ◽

Helicobacter Pylori Eradication ◽

Standard Triple Therapy ◽

Probiotic Treatment ◽

H Pylori ◽

Standard Treatment Regimen

The primary objective of this study was to evaluate the effect of age, gender, and the use of probiotics with standard treatment regimen on Helicobacter pylori eradication. Based on endoscopic findings and clinical presentation, selected patients were treated with standard triple therapy (omeprazole, clarithromycin, and amoxicillin). Those who failed were offered a repeat treatment with omeprazole, metronidazole, and amoxicillin. After the publications of the possible advantages of probiotic treatment on H pylori eradication, the probiotic agent “Probiotica Forte” was routinely added to the treatment. Eradication was noted for 94/130 patients (72%) and for 128/197 patients (65%) with or without probiotic agent, respectively ( P = .23). For second-line treatment eradication was noted in 33/46 (72%) and in 9/20 (45%) with or without probiotic agent, respectively ( P = .053). The addition of probiotics may improve eradication success especially in addition to second-line treatment.

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Evaluation of the Effectiveness of Helicobacter pylori Eradication Regimens in Lithuania during the Years 2013–2020: Data from the European Registry on Helicobacter pylori Management (Hp-EuReg)

Medicina ◽

10.3390/medicina57070642 ◽

2021 ◽

Vol 57 (7) ◽

pp. 642

Author(s):

Paulius Jonaitis ◽

Juozas Kupcinskas ◽

Olga P. Nyssen ◽

Ignasi Puig ◽

Javier P. Gisbert ◽

...

Keyword(s):

Helicobacter Pylori ◽

Triple Therapy ◽

Diagnostic Methods ◽

Line Treatment ◽

Second Line ◽

First Line ◽

Intention To Treat ◽

H Pylori ◽

Cure Rates ◽

European Registry

Background and Objectives: The prevalence of H. pylori in Eastern Europe remains quite high; however, there is insufficient data on the eradication regimens and their effectiveness. Therefore, the objective of the study was to evaluate the diagnostic methods and treatment of H. pylori infection as well as their adherence to Maastricht V/Florence consensus during the years 2013–2020 in Lithuania. Materials and Methods: Sub-study of the “European Registry on H. pylori Management” (Hp-EuReg), international multicenter prospective non-interventional registry of the routine clinical practice. Lithuanian data from the years 2013–2020 were analyzed for effectiveness on a modified intention-to-treat (mITT) basis. 2000 adult patients, diagnosed with H. pylori infection, were included. Data were compared to the European Maastricht V guidelines. Results: Triple-therapy was used in 90% of the cases. In 91% of the first-line prescriptions, standard triple therapy (STT) was used. The most common second-line treatment was a combination of PPI, amoxicillin and levofloxacin (PPI+A+L) (47%). The overall effectiveness in 552 cases valid for analysis was 90% by mITT. In first-line treatment, the STT effectiveness was 90% and second-line treatment with PPI+A+L achieved 92% by mITT. Increasing overall H. pylori eradication rates were observed: from 72% in 2013 to more than 90% in 2018–2020, as well as a shift from 7 to 10–14 days treatments duration throughout 2013–2020. Conclusions: In Lithuania, the prescribed eradication regimens for H. pylori were in accordance with the international guidelines but diagnostic methods and treatment duration only partially met Maastricht V/Florence guidelines. The eradication effectiveness was improved progressively during the years 2018–2020, reaching ≥90% cure rates.

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Proton Pump Inhibitor Switching Strategy after Failure of Standard Triple Therapy for Helicobacter pylori Infection

The Korean Journal of Helicobacter and Upper Gastrointestinal Research ◽

10.7704/kjhugr.2019.0036 ◽

2020 ◽

Vol 20 (2) ◽

pp. 146-152

Author(s):

Jaeyoung Kim ◽

Yeon-Ji Kim ◽

Woo Chul Chung

Keyword(s):

Helicobacter Pylori ◽

Proton Pump Inhibitor ◽

Triple Therapy ◽

Proton Pump ◽

Eradication Rate ◽

Control Group ◽

Second Line ◽

Observation Study ◽

Standard Triple Therapy ◽

H Pylori

Background/Aims: It is still unknown whether cytochrome P450 (CYP) 2C19 polymorphisms influence Helicobacter pylori (H. pylori) eradication, especially in eastern Asia. We aimed to evaluate how changes in proton pump inhibitor (PPI) strategies could be used to overcome the effects of CYP2C19 polymorphism on H. pylori eradication rate when it is used as the second-line regimen after the failure of standard triple therapy.Materials and Methods: We performed a retrospective observation study of 675 patients in whom standard triple therapy for H. pylori infection was not effective between January 2009 to December 2018. All patients underwent a classic bismuth-containing quadruple therapy (10 to 14-day regimen), and their eradication rates were evaluated for several years. We compared the eradication rates in patients with or without the second-line PPI switch. Further, we assessed differences in eradication rates with or without the strategy using esomeprazole and rabeprazole, which are not influenced significantly by CYP2C19 genetic polymorphism.Results: The eradication rate was 81.0% in individuals who received the second-line PPI switch, but it was 74.8% without switching (P=0.14). In the strategy using esomeprazole and rabeprazole, the eradication rate was 84.6%, compared to 76.5% in the control group (P=0.03). Finally, in the group of patients who switched to rabeprazole, the eradication rates were 85.6%, compared to 77.6% in the group who switched to pantoprazole (P=0.05).Conclusions: Switching to PPI, which is not influenced by CYP2C19 genetic polymorphism, increases the efficiency of eradication after the failure of standard triple therapy.

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Ranitidine bismuth citrate plus levofloxacin and tinidazole as second-line treatment for helicobacter pylori infection after failure of standard triple therapy

Digestive and Liver Disease ◽

10.1016/s1590-8658(01)80258-9 ◽

2001 ◽

Vol 33 ◽

pp. A26

Author(s):

A. Magnano ◽

S. Greco ◽

C. Favara ◽

A. Calzona ◽

A. Russo

Keyword(s):

Helicobacter Pylori ◽

Triple Therapy ◽

Helicobacter Pylori Infection ◽

Line Treatment ◽

Second Line ◽

Bismuth Citrate ◽

Standard Triple Therapy

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Standard Triple Therapy versus Sequential Therapy inHelicobacter pyloriEradication: A Double-Blind, Randomized, and Controlled Trial

Gastroenterology Research and Practice ◽

10.1155/2015/818043 ◽

2015 ◽

Vol 2015 ◽

pp. 1-5 ◽

Cited By ~ 3

Author(s):

Jaime Natan Eisig ◽

Tomás Navarro-Rodriguez ◽

Ana Cristina Sá Teixeira ◽

Fernando Marcuz Silva ◽

Rejane Mattar ◽

...

Keyword(s):

Triple Therapy ◽

Controlled Trial ◽

Sequential Therapy ◽

Rapid Urease Test ◽

Double Blind ◽

Intention To Treat ◽

Standard Triple Therapy ◽

Urease Test ◽

H Pylori ◽

Triple Treatment

Aim. To compare 10-day standard triple therapy versus sequential therapy as first-line treatment in patients infected withH. pylori.Methods. One hundredH. pyloripositive patients (diagnosed by rapid urease test and histology), with average age of 47.2, M/F = 28/72, were randomized to receive either standard triple treatment (TT) as follows: lansoprazole 30 mg, clarithromycin 500 mg, and amoxicillin 1 g, b.i.d. for ten days, or sequential treatment (ST) as follows: lansoprazole 30 mg, amoxicillin and placebo 1.0 g b.i.d for the first five days, followed by lansoprazole 30 mg, clarithromycin 500 mg, and tinidazole 500 mg b.i.d, for the remaining five days. Eradication rates were determined 60 days after treatment by urease, histology, or13C-urea breath test.Results. In intention to treat (ITT) analysis, the rate ofH. pylorieradication in the TT and ST groups was the same for both regimens as follows: 86% (43/50), 95% CI 93,3 to 73.4%. In Per protocol (PP) analysis, the rate ofH. pylorieradication in the TT and ST groups was 87.8% (43/49), 95% CI 94,5 to 75.3% and 89.6% (43/48), 95% CI 95,8 to 77.3%, respectively.Conclusions. In Brazil, standard triple therapy is as equally effective as sequential therapy in eradicatingHelicobacter pyloripatients. This study was registered under Clinical Trials with numberISRCTN62400496.

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