Department of Clinical Pharmacy and Pharmacy Practice, Faculty of Pharmacy, Damanhour University, Damanhour, Egypt.
Tropical Medicine and Hygiene Department, Damanhour Medical National Institute, Damanhour, Egypt.
Indian J Pharmacol. 2020 Sep-Oct;52(5):356-364. doi: 10.4103/ijp.IJP_364_19.
Levofloxacin-based triple therapies are considered the standard regimen for eradication of Helicobacter pylori (H. pylori) due to decreased sensitivity to clarithromycin and the optimal duration of therapy is still controversial. Besides, there is no complete evidence about dexlansoprazole efficacy in the eradication of H. pylori.
Our study aimed to determine the effectiveness of triple therapy based on levofloxacin-dexlansoprazole as a standard treatment for H. pylori infection and estimate the effect of H. pylori on lipid profile and hemoglobin (Hb).
A pilot prospective randomized trial of a triple therapy based on levofloxacin-dexlansoprazole for H. pylori eradication was conducted at Damanhour Medical National Institute, Egypt; 66 participants with H. pylori infection received levofloxacin (500 mg/day) plus amoxicillin (1 g/12 h) plus dexlansoprazole (60 mg/day). All medications administrated orally for either 7 days or 10 days. Four weeks after treatment, the eradication was assessed by the stool antigen test.
The rate of eradication was 63.6% in levofloxacin, amoxicillin, and dexlansoprazole (LAD) 7-day group, and 90.9% in LAD 10-day group. In addition, laboratory test results showed a significant difference in Hb, low-density lipoprotein, high-density lipoprotein, triglyceride, and total cholesterol levels before and after treatment (P < 0.05).
LAD 10 days is the least duration that provides maximum efficacy for H. pylori in Egyptian participants. In addition, successful treatment of H. pylori infection may reduce the risk of anemia and dyslipidemia. Furthermore, all members of the patient's family should be screened for H. pylori to prevent recurrent infection.
由于克拉霉素敏感性降低和最佳治疗持续时间仍存在争议，以左氧氟沙星为基础的三联疗法被认为是根除幽门螺杆菌 (H. pylori) 的标准方案。此外，尚无关于右旋兰索拉唑在根除 H. pylori 方面疗效的完整证据。
本研究旨在确定以左氧氟沙星-右旋兰索拉唑为基础的三联疗法作为 H. pylori 感染标准治疗的有效性，并评估 H. pylori 对血脂谱和血红蛋白 (Hb) 的影响。
在埃及达曼胡尔医学国立研究所进行了一项以左氧氟沙星-右旋兰索拉唑为基础的三联疗法根除 H. pylori 的前瞻性随机试验；66 例 H. pylori 感染患者接受左氧氟沙星（500mg/天）加阿莫西林（1g/12 小时）加右旋兰索拉唑（60mg/天）治疗。所有药物均口服，疗程为 7 天或 10 天。治疗 4 周后，通过粪便抗原试验评估根除率。
左氧氟沙星、阿莫西林和右旋兰索拉唑（LAD）7 天组的根除率为 63.6%，LAD 10 天组的根除率为 90.9%。此外，实验室检测结果显示治疗前后 Hb、低密度脂蛋白、高密度脂蛋白、甘油三酯和总胆固醇水平有显著差异（P<0.05）。
LAD 10 天是为埃及参与者提供最大 H. pylori 疗效的最短疗程。此外，成功治疗 H. pylori 感染可能降低贫血和血脂异常的风险。此外，所有患者家庭成员都应进行 H. pylori 筛查，以防止再次感染。
