Tariq Hassan, Patel Harish, Kamal Muhammad Umar, Abbas Naeem, Ameen Muhammad, Azam Sara, Kumar Kishore, Ravi Madhavi, Vootla Vamshidhar, Shaikh Danial, Amanchi Vamsi, Hussain Ali N, Makker Jasbir
Department of Medicine, BronxCare Health System, Bronx, NY 10457, USA.
Division of Gastroenterology, BronxCare Health System, Bronx, NY 10457, USA.
Clin Exp Gastroenterol. 2020 Jan 22;13:25-33. doi: 10.2147/CEG.S239343. eCollection 2020.
is a common cause of gastritis, peptic ulcer disease, and non-ulcer dyspepsia, and is also associated with gastric adenocarcinoma and mucosa associated lymphoid tissue lymphoma. Despite being known about for more than 30 years, finding an effective therapeutic strategy against it remains a challenge.
There are no US studies evaluating the efficacy of a Levofloxacin based therapy for infection. We here intend to study the efficacy of Levofloxacin based triple antibiotic regimen as compared to Clarithromycin based triple therapy and Bismuth based quadruple therapy in our patient population.
This is a retrospective single center observational study. Patients with infection who underwent treatment for with one of the three therapies, i.e. Clarithromycin triple, Bismuth Quadruple or Levofloxacin triple, were included in the study and the eradication rates were compared. The confirmation of the was done 4 weeks after the completion of anti-microbial therapy.
A total of 177 individuals underwent the treatment in our retrospective review. Of these, 54% (n=97) of patients were treated with Clarithromycin based triple therapy (Group 1), 35% (n=63) were treated with Levofloxacin based regimen (Group 2), and the remaining 11% (n=17) were treated with Bismuth based quadruple therapy (Group 3). The eradication rates were significantly higher in patients treated with Clarithromycin based triple therapy as compared to Levofloxacin based triple therapy and Bismuth quadruple therapy (78.3% vs 49.2% vs 41.1% =0.001).
In conclusion, our study shows significantly lower eradication rates with Levofloxacin triple therapy among a selected US population. Thus, it may not be a good first-line therapy among this US population and the Clarithromycin based regimen may still be used successfully.
幽门螺杆菌是胃炎、消化性溃疡病和非溃疡性消化不良的常见病因，还与胃腺癌和黏膜相关淋巴组织淋巴瘤有关。尽管已被知晓30多年，但找到针对它的有效治疗策略仍是一项挑战。
美国尚无评估基于左氧氟沙星的疗法治疗幽门螺杆菌感染疗效的研究。我们在此旨在研究在我们的患者群体中，基于左氧氟沙星的三联抗生素方案与基于克拉霉素的三联疗法和基于铋剂的四联疗法相比的疗效。
这是一项回顾性单中心观察性研究。接受三种疗法之一（即克拉霉素三联疗法、铋剂四联疗法或左氧氟沙星三联疗法）治疗幽门螺杆菌感染的患者被纳入研究，并比较根除率。在抗菌治疗完成4周后确认幽门螺杆菌感染情况。
在我们的回顾性研究中，共有177人接受了幽门螺杆菌治疗。其中，54%（n = 97）的患者接受了基于克拉霉素的三联疗法（第1组），35%（n = 63）的患者接受了基于左氧氟沙星的方案（第2组），其余11%（n = 17）的患者接受了基于铋剂的四联疗法（第3组）。与基于左氧氟沙星的三联疗法和铋剂四联疗法相比，接受基于克拉霉素的三联疗法治疗的患者根除率显著更高（78.3%对49.2%对41.1%，P = 0.001）。
总之，我们的研究表明，在特定的美国人群中，左氧氟沙星三联疗法的根除率显著较低。因此，在该美国人群中，它可能不是一种良好的一线疗法，基于克拉霉素的方案可能仍可成功使用。
