Telaku Skender, Manxhuka-Kerliu Suzana, Kraja Bledar, Qirjako Gentiana, Prifti Skerdi, Fejza Hajrullah
Department of Gastroenterology, Clinical University Centre of Kosovo, Pristina, Kosovo.
University Clinic of Gastrohepatology, University Hospital Center "Mother Theresa", Tirana, Albania.
Med Arch. 2013;67(5):348-50. doi: 10.5455/medarh.2013.67.348-350.
Because of the increasing resistance to clarithromycin and metronidazole, new therapeutic alternatives are needed. The purpose of this study was to compare the efficacy of 7- and 10-day triple therapy including omeprazole, levofloxacin and amoxicilline for Helicobacter pylori eradication as a first-line therapy.
One hundred and five patients with peptic ulcer disease and with non-ulcer dyspepsia infected with Helicobacter pylori were included in this study. Patients were randomized to receive either 7-day or 10-day therapy with omeprazole (20 mg b.i.d.), plus levofloxacin (500 mg o.i.d.) and amoxicilline (1000 mg b.i.d.). Eradication was assessed by negative histological analyses, negative H. pylori stool antigen or rapid urease test.
In Group 1, the eradication rate was 86, 2%, while in group 2, eradication rate was 93,6%. There was no difference between groups (p=0.218). Adverse effects were reported in 5, 25% of the patients, including nausea and diarrhea.
The levofloxacin-based regimen can be one effective therapy for the first-line anti-H. pylori treatment. However, a levofloxacin-based triple therapy is not generally recommended as first-line therapy at the moment due to concerns about the rising prevalence of quinolone-resistant strains in the first-line and second-line anti-H. pylori therapies.
由于对克拉霉素和甲硝唑的耐药性不断增加，需要新的治疗选择。本研究的目的是比较包含奥美拉唑、左氧氟沙星和阿莫西林的7天和10天三联疗法作为一线疗法根除幽门螺杆菌的疗效。
本研究纳入了105例患有消化性溃疡疾病且感染幽门螺杆菌的非溃疡性消化不良患者。患者被随机分配接受7天或10天的治疗，治疗方案为奥美拉唑（20毫克，每日两次）加左氧氟沙星（500毫克，每日四次）和阿莫西林（1000毫克，每日两次）。通过组织学分析阴性、幽门螺杆菌粪便抗原阴性或快速尿素酶试验评估根除情况。
第1组的根除率为86.2%，而第2组的根除率为93.6%。两组之间无差异（p = 0.218）。5.25%的患者报告了不良反应，包括恶心和腹泻。
基于左氧氟沙星的治疗方案可能是一线抗幽门螺杆菌治疗的一种有效疗法。然而，由于担心在一线和二线抗幽门螺杆菌治疗中喹诺酮耐药菌株的患病率上升，目前一般不推荐将基于左氧氟沙星的三联疗法作为一线疗法。
