Please use this identifier to cite or link to this item:
https://hdl.handle.net/10316/108103
DC Field | Value | Language |
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dc.contributor.author | Branquinho, Diogo | - |
dc.contributor.author | Almeida, Nuno | - |
dc.contributor.author | Gregório, Carlos | - |
dc.contributor.author | Cabral, José Eduardo Pina | - |
dc.contributor.author | Casela, Adriano | - |
dc.contributor.author | Donato, Maria Manuel | - |
dc.contributor.author | Tomé, Luís | - |
dc.date.accessioned | 2023-08-11T09:56:53Z | - |
dc.date.available | 2023-08-11T09:56:53Z | - |
dc.date.issued | 2017-02-15 | - |
dc.identifier.issn | 1471-230X | pt |
dc.identifier.uri | https://hdl.handle.net/10316/108103 | - |
dc.description.abstract | Background: Helicobacter pylori eradication rates in Portugal are declining, due to increased resistance of this bacterium to antimicrobial agents, especially Clarithromycin. Quadruple Levofloxacin-containing regimens could be an option for first-line treatment, but its efficacy should be evaluated as fluoroquinolone resistance is rapidly increasing. Our aim was to compare the efficacy of Clarithromycin and Levofloxacin-based sequential quadruple therapies as first-line treatment options and determine factors associated with treatment failure. Methods: A total of 200 Helicobacter pylori infected patients were retrospectively included (female 57.5%; average age: 53.2 ± 15.7) and received either 10-day sequential therapy (Proton-Pump Inhibitor + Amoxicillin 1 g bid for 5 days and Proton-Pump Inhibitor + Clarithromycin 500 mg + Metronidazole/Tinidazole 500 mg bid/tid in the following 5 days; group A) or a 10-day modified sequential therapy with Levofloxacin 500 mg id instead of Clarithromycin (group B). Eradication was confirmed with urea breath test. Variables that could influence success rate were analyzed. Results: There were no differences between groups in terms of gender, age, smoking habits and indications for treatment. The eradication rate obtained with Clarithromycin-based sequential treatment was significantly higher than with Levofloxacin-based therapy (90%, CI95%: 84–96% vs. 79%, CI95%: 71–87%, p = 0.001). Using full-dose proton-pump inhibitor and high-dose Metronidazole in group A, and full-dose proton-pump inhibitor and prescription from a Gastroenterologist in group B were associated with eradication success. Conclusions: Ten-day Levofloxacin-based sequential treatment achieved inadequate efficacy rate (<80%) and should not be adopted as first-line therapy. Standard sequential therapy showed significantly better results in this naïve population. Using full-dose proton-pump inhibitor and higher doses of Metronidazole is essential to achieve such results. | pt |
dc.language.iso | eng | pt |
dc.publisher | Springer Nature | pt |
dc.rights | openAccess | pt |
dc.rights.uri | http://creativecommons.org/licenses/by/4.0/ | pt |
dc.subject | Eradication | pt |
dc.subject | First-line | pt |
dc.subject | Helicobacter pylori | pt |
dc.subject | Levofloxacin | pt |
dc.subject | Sequential therapy | pt |
dc.subject.mesh | Adolescent | pt |
dc.subject.mesh | Adult | pt |
dc.subject.mesh | Aged | pt |
dc.subject.mesh | Aged, 80 and over | pt |
dc.subject.mesh | Amoxicillin | pt |
dc.subject.mesh | Anti-Bacterial Agents | pt |
dc.subject.mesh | Clarithromycin | pt |
dc.subject.mesh | Drug Resistance, Bacterial | pt |
dc.subject.mesh | Drug Therapy, Combination | pt |
dc.subject.mesh | Female | pt |
dc.subject.mesh | Helicobacter Infections | pt |
dc.subject.mesh | Humans | pt |
dc.subject.mesh | Levofloxacin | pt |
dc.subject.mesh | Male | pt |
dc.subject.mesh | Metronidazole | pt |
dc.subject.mesh | Middle Aged | pt |
dc.subject.mesh | Portugal | pt |
dc.subject.mesh | Proton Pump Inhibitors | pt |
dc.subject.mesh | Retrospective Studies | pt |
dc.subject.mesh | Tinidazole | pt |
dc.subject.mesh | Treatment Outcome | pt |
dc.subject.mesh | Young Adult | pt |
dc.subject.mesh | Helicobacter pylori | pt |
dc.title | Levofloxacin or Clarithromycin-based quadruple regimens: what is the best alternative as first-line treatment for Helicobacter pylori eradication in a country with high resistance rates for both antibiotics? | pt |
dc.type | article | - |
degois.publication.firstPage | 31 | pt |
degois.publication.issue | 1 | pt |
degois.publication.title | BMC Gastroenterology | pt |
dc.peerreviewed | yes | pt |
dc.identifier.doi | 10.1186/s12876-017-0589-6 | pt |
degois.publication.volume | 17 | pt |
dc.date.embargo | 2017-02-15 | * |
uc.date.periodoEmbargo | 0 | pt |
item.fulltext | Com Texto completo | - |
item.openairecristype | http://purl.org/coar/resource_type/c_18cf | - |
item.languageiso639-1 | en | - |
item.openairetype | article | - |
item.cerifentitytype | Publications | - |
item.grantfulltext | open | - |
crisitem.author.orcid | 0000-0001-8519-6409 | - |
crisitem.author.orcid | 0000-0003-0499-5888 | - |
Appears in Collections: | FMUC Medicina - Artigos em Revistas Internacionais |
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