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

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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.	苏秉忠. 合理用药提高幽门螺杆菌根除率[J]. 内蒙古医学杂志, 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.	丁禄荣, 庄彦华, 艾江, 等. 补救治疗根除幽门螺杆菌失败病例的临床观察[J]. 牡丹江医学院学报, 2008, 29(3):52-53.
4.	马春曦, 彭国林, 张晓云. 新三联方案根除幽门螺杆菌的疗效观察[J]. 东南国防医药, 2008, 10(3):192-194.
5.	周颖, 陆思源. 左氧氟沙星三联疗法根除幽门螺杆菌临床观察[J]. 中华现代内科学杂志, 2008, 5(1):531-532.
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7.	粱志根. 全华斌, 何善智. 左氧氟沙星、阿莫西林、埃索美拉唑三联疗法在幽门螺杆菌补救治疗的临床研究[J]. 海南医学, 2007, 18(7):1-3.
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9.	段雪辉, 尹合坤. 含左氧氟沙星三联疗法根除幽门螺杆菌的临床研究[J]. 实用临床医药杂志, 2012, 16(5):69-71.
10.	高元平, 郝卫刚, 张延涛. 含铋剂及左氧氟沙星四联疗法根除幽门螺杆菌疗效分析[J]. 现代医药卫生, 2011, 27(21):3234-3236.
11.	陈建儿, 郭淦华, 沈建冲, 等. 含左氧氟沙星序贯疗法对幽门螺杆菌感染补救治疗的疗效分析[J]. 中国现代医生, 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.
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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.	杨宪武, 赵逵, 张晓博. 根除幽门螺杆菌失败33例相关因素分析[J]. 华西医学, 2010,25(5):837-839.
20.	王登映. 根除幽门螺杆菌与治疗糖尿病性胃轻瘫的疗效分析[J]. 华西医学, 2010, 25(2):253-254.
21.	靳红, 斯锞. 根除幽门螺杆菌对糖尿病胃轻瘫的治疗作用研究[J]. 华西医学, 2011, 26(2):189-191.
22.	华影, 董卫国, 吕晓光. 幽门螺旋杆菌阳性患者首次根除治疗失败后二线治疗方案的循证医学证据[J]. 中国循证医学杂志, 2011, 11(4):473-476.
23.	程君, 王迎迎, 李慧, 等. 合肥市产超广谱β-内酰胺酶菌株的SHV型耐药基因分布和耐药性分析[J]. 中国药理学通报, 2007, 23(6):812-815.
24.	秦秀兰, 温悦, 孟德胜. 某综合性三级甲等医院门/急诊质子泵抑制剂合并用药情况分析[J]. 中国药房, 2010(46):4340-4342.
25.	钱韶红, 韦晓静, 王丽. 四联疗法联合丹参根除幽门螺杆菌的临床治疗[J]. 中国医院药学杂志, 2012, 32(15):1230-1232.
26.	张庆, 胡承明, 谭小平, 等. 含呋喃唑酮三联方案不同疗程治疗幽门螺杆菌的疗效观察[J]. 中国医院药学杂志, 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. 苏秉忠. 合理用药提高幽门螺杆菌根除率[J]. 内蒙古医学杂志, 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. 丁禄荣, 庄彦华, 艾江, 等. 补救治疗根除幽门螺杆菌失败病例的临床观察[J]. 牡丹江医学院学报, 2008, 29(3):52-53.
4. 马春曦, 彭国林, 张晓云. 新三联方案根除幽门螺杆菌的疗效观察[J]. 东南国防医药, 2008, 10(3):192-194.
5. 周颖, 陆思源. 左氧氟沙星三联疗法根除幽门螺杆菌临床观察[J]. 中华现代内科学杂志, 2008, 5(1):531-532.
6. 张昊, 于静, 贾长河. 用三联法根除幽门螺杆菌失败后的补救方案[J]. 中国临床药理学杂志, 2008, 24(4):361-363.
7. 粱志根. 全华斌, 何善智. 左氧氟沙星、阿莫西林、埃索美拉唑三联疗法在幽门螺杆菌补救治疗的临床研究[J]. 海南医学, 2007, 18(7):1-3.
8. 杜勇, 宋军, 卢光新, 等. 不同治疗方案在幽门螺旋杆菌复治失败后的应用比较[J]. 实用医学杂志, 2006, 22(5):574-575.
9. 段雪辉, 尹合坤. 含左氧氟沙星三联疗法根除幽门螺杆菌的临床研究[J]. 实用临床医药杂志, 2012, 16(5):69-71.
10. 高元平, 郝卫刚, 张延涛. 含铋剂及左氧氟沙星四联疗法根除幽门螺杆菌疗效分析[J]. 现代医药卫生, 2011, 27(21):3234-3236.
11. 陈建儿, 郭淦华, 沈建冲, 等. 含左氧氟沙星序贯疗法对幽门螺杆菌感染补救治疗的疗效分析[J]. 中国现代医生, 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. 杨宪武, 赵逵, 张晓博. 根除幽门螺杆菌失败33例相关因素分析[J]. 华西医学, 2010,25(5):837-839.
20. 王登映. 根除幽门螺杆菌与治疗糖尿病性胃轻瘫的疗效分析[J]. 华西医学, 2010, 25(2):253-254.
21. 靳红, 斯锞. 根除幽门螺杆菌对糖尿病胃轻瘫的治疗作用研究[J]. 华西医学, 2011, 26(2):189-191.
22. 华影, 董卫国, 吕晓光. 幽门螺旋杆菌阳性患者首次根除治疗失败后二线治疗方案的循证医学证据[J]. 中国循证医学杂志, 2011, 11(4):473-476.
23. 程君, 王迎迎, 李慧, 等. 合肥市产超广谱β-内酰胺酶菌株的SHV型耐药基因分布和耐药性分析[J]. 中国药理学通报, 2007, 23(6):812-815.
24. 秦秀兰, 温悦, 孟德胜. 某综合性三级甲等医院门/急诊质子泵抑制剂合并用药情况分析[J]. 中国药房, 2010(46):4340-4342.
25. 钱韶红, 韦晓静, 王丽. 四联疗法联合丹参根除幽门螺杆菌的临床治疗[J]. 中国医院药学杂志, 2012, 32(15):1230-1232.
26. 张庆, 胡承明, 谭小平, 等. 含呋喃唑酮三联方案不同疗程治疗幽门螺杆菌的疗效观察[J]. 中国医院药学杂志, 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

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