Gastroenterology Service Territoriale, ASL BAT, Andria-BT, Italy.
J Gastrointestin Liver Dis. 2012 Jun;21(2):133-8.
Failure in the eradication of H. pylori is a frequent occurrence. We assessed the effectiveness of a third-line, levofloxacin-containing, 10-day sequential treatment, in order to obtain eradication of H. pylori resistant patients in a clinical setting.
One-hundred and nineteen consecutive patients with proven two consecutive failures in curing H. pylori infection, containing either clarithromycin, bismuth or levofloxacin, were prospectively assessed. All patients received a 10-day sequential therapy with proton pump inhibitor (PPI) plus amoxicillin 1 g for the first 5 days, followed by PPI, levofloxacin 500 mg and tetracycline 500 mg for the remaining 5 days (all twice daily). One month after conclusion of therapy, endoscopy was performed in those patients for whom the examinations were clinically relevant. The remaining patients were checked by ¹³C-urea breath test.
H. pylori eradication was obtained in 80 patients (per-protocol: 68.38%; on intention-to-treat: 67.23%). Twenty-nine patients (24.37%) experienced side-effects, but only two of them (1.68%) were withdrawn from the study.
A 10-day sequential triple therapy containing amoxicillin, levofloxacin and tetracycline seems to be effective and safe in curing resistant H. pylori infection.
幽门螺杆菌根除失败较为常见。我们评估了一种三线、含左氧氟沙星、10 天序贯治疗方案的疗效，以期在临床环境中获得耐药幽门螺杆菌感染患者的根除。
连续前瞻性评估了 119 例已知连续两次克拉霉素、铋剂或左氧氟沙星治疗失败的患者。所有患者均接受质子泵抑制剂（PPI）加阿莫西林 1g 治疗 5 天的 10 天序贯治疗，随后 PPI、左氧氟沙星 500mg 和四环素 500mg 治疗 5 天（均每日 2 次）。对于有临床意义的检查，治疗结束后 1 个月对这些患者进行内镜检查。其余患者通过¹³C-尿素呼气试验进行检查。
80 例患者（符合方案：68.38%；意向治疗：67.23%）获得了幽门螺杆菌根除。29 例（24.37%）患者出现不良反应，但仅有 2 例（1.68%）患者退出研究。
含阿莫西林、左氧氟沙星和四环素的 10 天序贯三联疗法治疗耐药幽门螺杆菌感染似乎是有效且安全的。
