Cammarota Giovanni, Cianci Rossella, Cannizzaro Oreste, Martino Antonio, Fedeli Paolo, Lecca Piera Giuseppina, di Caro Simona, Cesaro Paola, Branca Giovanna, Gasbarrini Giovanni
Department of Internal Medicine, Institute of Microbiology, Catholic University of Rome, Italy.
J Clin Gastroenterol. 2004 Feb;38(2):110-4. doi: 10.1097/00004836-200402000-00005.
To compare high-dose versus low-dose clarithromycin in 1-week triple therapy including rabeprazole and levofloxacin.
Regimens containing rabeprazole and levofloxacin have proved to be effective against H. pylori infection.
One-hundred H. pylori-positive patients were randomly assigned to one of the following 1-week regimens: rabeprazole 20 mg o.d. plus levofloxacin 500 mg o.d. and clarithromycin 250 mg b.d. (RLC-1 group); rabeprazole 20 mg o.d. plus levofloxacin 500 mg o.d. and clarithromycin 500 mg b.d. (RLC-2 group). H. pylori status was assessed at entry and after the treatment. Patients who experienced treatment failure underwent antibiotic susceptibility testing.
Forty-two patients in RLC-1 group (both PP and ITT analysis: 84%; 95%CI: 71-93%) and 47 in RLC2 group (both PP and ITT analysis: 94%; 95% CI: 83-98%) became H. pylori negative. Clarithromycin resistance was detected in all of 8 (100%) RLC-1 failures and in 1 out of 3 (33%) RLC-2 failures. Side effects occurred in 8% of patients in RLC-1 group and in 12% in RLC-2.
Regimens tested are competitive with other PPI-based treatments. One-week triple therapy containing rabeprazole plus, levofloxacin, and high-dose clarithromycin yielded a higher eradicating rate than the one containing low-dose clarithromycin and may be considered as a first-line therapy option.
比较含雷贝拉唑和左氧氟沙星的1周三联疗法中高剂量与低剂量克拉霉素的疗效。
含雷贝拉唑和左氧氟沙星的治疗方案已被证明对幽门螺杆菌感染有效。
100例幽门螺杆菌阳性患者被随机分配至以下1周治疗方案之一：雷贝拉唑20毫克每日一次，加左氧氟沙星500毫克每日一次和克拉霉素250毫克每日两次（RLC - 1组）；雷贝拉唑20毫克每日一次，加左氧氟沙星500毫克每日一次和克拉霉素500毫克每日两次（RLC - 2组）。在入组时和治疗后评估幽门螺杆菌状态。经历治疗失败的患者进行抗生素敏感性测试。
RLC - 1组42例患者（PP和ITT分析均为：84%；95%CI：71 - 93%）和RLC - 2组47例患者（PP和ITT分析均为：94%；95%CI：83 - 98%）幽门螺杆菌转为阴性。在RLC - 1组所有8例（100%）治疗失败患者中检测到克拉霉素耐药，在RLC - 2组3例治疗失败患者中有1例（33%）检测到。RLC - 1组8%的患者出现副作用，RLC - 2组为12%。
所测试方案与其他基于质子泵抑制剂的治疗方案具有竞争力。含雷贝拉唑、左氧氟沙星和高剂量克拉霉素的1周三联疗法比含低剂量克拉霉素的疗法根除率更高，可被视为一线治疗选择。
