Yusuf AYDIN, Yaşar NAZLIGÜL, Abdullah Ö. YENİOVA, Ayşe KEFELİ, Gülçin ŞİMŞEK, Muhammed SAÇIKARA, İbrahim Halil AKKUŞ

The efficacy of levofloxacin-based triple therapy for first-line Helicobacter pylori eradication

Amaç: İlk basamak H.pilori eradikasyonunda Türkiye\'de ve Dünya\'da en çok tercih edilen tedavi protokolü proton pompa inhibitörü, klaritromisin ve amoksisilin içeren standart tedavi rejimidir. Ancak artan klaritromisin direnci sebe-biyle alternatif tedavi rejimleri araştırılmaktadır. Çalışmamızda standart üçlü tedavi rejimindeki klaritromisin yerine le-vofloksasin getirilmesiyle oluşturulan kombinasyonun etkinliğini araştırdık. Gereç ve yöntem: Çalışma, H.pilori ile enfekte 52 kadın, 29 erkek, toplam 81 nonülser dispepsi hastasında tamam-landı (yaş ortalaması 46,3 ± 13,9). Tedavide âlansoprazol 30mg 2x1, levofloksasin 500 mg 1x1, amoksisilin 1 gr 2x1â 7 gün verildi. Tedavi bitiminden 6-8 hafta sonra C14 üre-nefes testiyle tedavinin etkinliği kontrol edildi. Bulgular: Hastaların % 68\'inde H.pilori negatifliği sağlandı. Eradikasyon sağlanan ve sağlanmayan hasta grupları yaş, sigara ve cinsiyet dağılımı yönünden benzer bulundu (p > 0,05). Sonuç: İlk basamak H.pilori eradikasyonunda 7 gün süreyle verilen levofloksasin temelli üçlü tedavi yeterince etkin değildir. Yeni tedavi protokollerine ihtiyaç duyulmaktadır.

Anahtar Kelimeler:

Helikobakter pilori, levofloksasin, ilk basamak tedavi.

The efficacy of levofloxacin-based triple therapy for first-line Helicobacter pylori eradication

Objectives: Standard triple therapy composed of a proton pump inhibitor, clarithromycin and amoxicillin has been widely preferred for H. pylori eradication in Turkey and World. Alternative therapies are currently under investigation because of an increase in clarithromycin resistance. The aim of this study was to evaluate the efficacy of a levoflox-acin-containing triple therapy. Materials and methods: The study was carried out in 81 H. pylori-infected patients (52 female, 29 male) with nonul-cer dyspepsia. The mean age was found 46.3 ± 13.9. Treatment was indicated with lansoprazol 30 mg b.d., amoxicil-lin 1 g b.d., and levofloxacin 500 mg daily for 7 days. H. pylori status was rechecked by (14)C urea breath test 6-8 weeks after the end of therapy. Results: Totally 81 patients could complete the treatment and follow-up protocol. Effectiveness was 68%. The distrib-tions of age, gender and smoking were similar between eradicated and non-eradicated groups (p > 0.05). Conclusion: Seven-day levofloxacin based triple therapy is not very effective in the first-line treatment of H. pylori in-fection. The new treatment modalities should be investigated.

Keywords:

Levofloxacin, Helicobacter pylori, first-line therapy.,

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