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Systematic review with meta‐analysis: the efficacy of levofloxacin triple therapy as the first‐ or second‐line treatments of Helicobacter pylori infection
Summary Background Levofloxacin triple therapy has been used for the first‐line and second‐line treatment of Helicobacter pylori infection for more than 10 years. Aims To systematically review the efficacy of levofloxacin triple therapy in the first‐ and second‐line treatment, and to assess the time...
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| Published in: | Alimentary pharmacology & therapeutics 2016-09, Vol.44 (5), p.427-437 |
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| container_end_page | 437 |
| container_issue | 5 |
| container_start_page | 427 |
| container_title | Alimentary pharmacology & therapeutics |
| container_volume | 44 |
| creator | Chen, P.‐Y. Wu, M.‐S. Chen, C.‐Y. Bair, M.‐J. Chou, C.‐K. Lin, J.‐T. Liou, J.‐M. |
| description | Summary
Background
Levofloxacin triple therapy has been used for the first‐line and second‐line treatment of Helicobacter pylori infection for more than 10 years.
Aims
To systematically review the efficacy of levofloxacin triple therapy in the first‐ and second‐line treatment, and to assess the time trend and factors that might affect its efficacy.
Methods
Prospective trials reporting the efficacy of levofloxacin triple therapy in either the first‐line or second‐line treatment of H. pylori infection in adults were searched from the PubMed and Cochrane database from January 2000 to September 2015. Meta‐analysis was performed to calculate the cumulative eradication rate and the efficacies in subgroups.
Results
Of the 322 articles identified, a total of 4574 patients from 41 trials, including 16 trials in the first‐line treatment and 25 trials in the second‐line treatment were eligible for analysis. The cumulative eradication rate was 77.3% (95% confidence intervals, CI: 74.7–79.6) and was 80.7% (95% CI 77.1–83.7) in the first‐line treatment and 74.5% (95% CI: 70.9–77.8) in the second‐line treatment. The efficacies of levofloxacin triple therapy before 2008, between 2009 and 2011, and after 2012 were 77.4%, 79.6% and 74.8% respectively. The eradication rate was higher when levofloxacin was given once daily (80.6%, 95% CI: 77.1–83.7) than twice daily (73.6%, 95% CI: 69.7–77.2). The efficacy was significantly higher in levofloxacin‐susceptible strains than resistant strains (81.1% vs. 36.3%, risk ratio 2.18, 95% CI: 1.6–3, P |
| doi_str_mv | 10.1111/apt.13712 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1809049586</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1809049586</sourcerecordid><originalsourceid>FETCH-LOGICAL-c5002-96d04863b6e6ab1f63fee8b0b5b391d8bf4e400ec3abe0e5d65306f90d6510383</originalsourceid><addsrcrecordid>eNp1kUFO3DAUQC3UCoaBBRdAXsIi8B1PPAk7hGhBQmql0nVkO9_CyImD7WHIrkfoEXq2ngQPA93Vm-8vPb2_eIQcMThj-Z3LMZ0xvmTlDpkxLqqiBC4-kRmUoinKmvE9sh_jIwCIJZS7ZK9ccsFFvZyRPz-mmLCXyWoa8Nnimq5teqA9Jvn31285SDdFGy9oekCKxlgt9US9oQ6fvXH-RWo70BTs6HDDBDlOVMY33NgQU5ZQH2hE7YcuL84OGQwoU49DihvVDTqrvZI6YaDj5Hyw1A4GdbJ-OCCfjXQRD9_nnPz8cn1_dVPcfft6e3V5V-gKoCwa0cGiFlwJFFIxI7hBrBWoSvGGdbUyC1wAoOZSIWDViYqDMA3kDwNe8zk52XrH4J9WGFPb26jROTmgX8WW1dDAoqnyjTk53aI6-BgDmnYMtpdhahm0myBtDtK-Bcns8bt2pXrs_pEfBTJwvgXW1uH0f1N7-f1-q3wF3LObvQ</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1809049586</pqid></control><display><type>article</type><title>Systematic review with meta‐analysis: the efficacy of levofloxacin triple therapy as the first‐ or second‐line treatments of Helicobacter pylori infection</title><source>Wiley</source><creator>Chen, P.‐Y. ; Wu, M.‐S. ; Chen, C.‐Y. ; Bair, M.‐J. ; Chou, C.‐K. ; Lin, J.‐T. ; Liou, J.‐M.</creator><creatorcontrib>Chen, P.‐Y. ; Wu, M.‐S. ; Chen, C.‐Y. ; Bair, M.‐J. ; Chou, C.‐K. ; Lin, J.‐T. ; Liou, J.‐M. ; Taiwan Gastrointestinal Disease and Helicobacter Consortium ; for the Taiwan Gastrointestinal Disease and Helicobacter Consortium</creatorcontrib><description>Summary
Background
Levofloxacin triple therapy has been used for the first‐line and second‐line treatment of Helicobacter pylori infection for more than 10 years.
Aims
To systematically review the efficacy of levofloxacin triple therapy in the first‐ and second‐line treatment, and to assess the time trend and factors that might affect its efficacy.
Methods
Prospective trials reporting the efficacy of levofloxacin triple therapy in either the first‐line or second‐line treatment of H. pylori infection in adults were searched from the PubMed and Cochrane database from January 2000 to September 2015. Meta‐analysis was performed to calculate the cumulative eradication rate and the efficacies in subgroups.
Results
Of the 322 articles identified, a total of 4574 patients from 41 trials, including 16 trials in the first‐line treatment and 25 trials in the second‐line treatment were eligible for analysis. The cumulative eradication rate was 77.3% (95% confidence intervals, CI: 74.7–79.6) and was 80.7% (95% CI 77.1–83.7) in the first‐line treatment and 74.5% (95% CI: 70.9–77.8) in the second‐line treatment. The efficacies of levofloxacin triple therapy before 2008, between 2009 and 2011, and after 2012 were 77.4%, 79.6% and 74.8% respectively. The eradication rate was higher when levofloxacin was given once daily (80.6%, 95% CI: 77.1–83.7) than twice daily (73.6%, 95% CI: 69.7–77.2). The efficacy was significantly higher in levofloxacin‐susceptible strains than resistant strains (81.1% vs. 36.3%, risk ratio 2.18, 95% CI: 1.6–3, P < 0.001).
Conclusion
The efficacy of levofloxacin triple therapy has been lower than 80% in many countries and it is not recommended when the levofloxacin resistance is higher than 5–10%.</description><identifier>ISSN: 0269-2813</identifier><identifier>EISSN: 1365-2036</identifier><identifier>DOI: 10.1111/apt.13712</identifier><identifier>PMID: 27363687</identifier><language>eng</language><publisher>England</publisher><subject>Adult ; Amoxicillin - administration & dosage ; Anti-Bacterial Agents - administration & dosage ; Clinical Trials as Topic - methods ; Databases, Factual ; Drug Resistance, Bacterial ; Drug Therapy, Combination ; Helicobacter Infections - diagnosis ; Helicobacter Infections - drug therapy ; Helicobacter pylori - drug effects ; Helicobacter pylori - physiology ; Humans ; Levofloxacin - administration & dosage ; Prospective Studies ; Treatment Outcome</subject><ispartof>Alimentary pharmacology & therapeutics, 2016-09, Vol.44 (5), p.427-437</ispartof><rights>2016 John Wiley & Sons Ltd</rights><rights>2016 John Wiley & Sons Ltd.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c5002-96d04863b6e6ab1f63fee8b0b5b391d8bf4e400ec3abe0e5d65306f90d6510383</citedby><cites>FETCH-LOGICAL-c5002-96d04863b6e6ab1f63fee8b0b5b391d8bf4e400ec3abe0e5d65306f90d6510383</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>315,783,787,27938,27939</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27363687$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Chen, P.‐Y.</creatorcontrib><creatorcontrib>Wu, M.‐S.</creatorcontrib><creatorcontrib>Chen, C.‐Y.</creatorcontrib><creatorcontrib>Bair, M.‐J.</creatorcontrib><creatorcontrib>Chou, C.‐K.</creatorcontrib><creatorcontrib>Lin, J.‐T.</creatorcontrib><creatorcontrib>Liou, J.‐M.</creatorcontrib><creatorcontrib>Taiwan Gastrointestinal Disease and Helicobacter Consortium</creatorcontrib><creatorcontrib>for the Taiwan Gastrointestinal Disease and Helicobacter Consortium</creatorcontrib><title>Systematic review with meta‐analysis: the efficacy of levofloxacin triple therapy as the first‐ or second‐line treatments of Helicobacter pylori infection</title><title>Alimentary pharmacology & therapeutics</title><addtitle>Aliment Pharmacol Ther</addtitle><description>Summary
Background
Levofloxacin triple therapy has been used for the first‐line and second‐line treatment of Helicobacter pylori infection for more than 10 years.
Aims
To systematically review the efficacy of levofloxacin triple therapy in the first‐ and second‐line treatment, and to assess the time trend and factors that might affect its efficacy.
Methods
Prospective trials reporting the efficacy of levofloxacin triple therapy in either the first‐line or second‐line treatment of H. pylori infection in adults were searched from the PubMed and Cochrane database from January 2000 to September 2015. Meta‐analysis was performed to calculate the cumulative eradication rate and the efficacies in subgroups.
Results
Of the 322 articles identified, a total of 4574 patients from 41 trials, including 16 trials in the first‐line treatment and 25 trials in the second‐line treatment were eligible for analysis. The cumulative eradication rate was 77.3% (95% confidence intervals, CI: 74.7–79.6) and was 80.7% (95% CI 77.1–83.7) in the first‐line treatment and 74.5% (95% CI: 70.9–77.8) in the second‐line treatment. The efficacies of levofloxacin triple therapy before 2008, between 2009 and 2011, and after 2012 were 77.4%, 79.6% and 74.8% respectively. The eradication rate was higher when levofloxacin was given once daily (80.6%, 95% CI: 77.1–83.7) than twice daily (73.6%, 95% CI: 69.7–77.2). The efficacy was significantly higher in levofloxacin‐susceptible strains than resistant strains (81.1% vs. 36.3%, risk ratio 2.18, 95% CI: 1.6–3, P < 0.001).
Conclusion
The efficacy of levofloxacin triple therapy has been lower than 80% in many countries and it is not recommended when the levofloxacin resistance is higher than 5–10%.</description><subject>Adult</subject><subject>Amoxicillin - administration & dosage</subject><subject>Anti-Bacterial Agents - administration & dosage</subject><subject>Clinical Trials as Topic - methods</subject><subject>Databases, Factual</subject><subject>Drug Resistance, Bacterial</subject><subject>Drug Therapy, Combination</subject><subject>Helicobacter Infections - diagnosis</subject><subject>Helicobacter Infections - drug therapy</subject><subject>Helicobacter pylori - drug effects</subject><subject>Helicobacter pylori - physiology</subject><subject>Humans</subject><subject>Levofloxacin - administration & dosage</subject><subject>Prospective Studies</subject><subject>Treatment Outcome</subject><issn>0269-2813</issn><issn>1365-2036</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><recordid>eNp1kUFO3DAUQC3UCoaBBRdAXsIi8B1PPAk7hGhBQmql0nVkO9_CyImD7WHIrkfoEXq2ngQPA93Vm-8vPb2_eIQcMThj-Z3LMZ0xvmTlDpkxLqqiBC4-kRmUoinKmvE9sh_jIwCIJZS7ZK9ccsFFvZyRPz-mmLCXyWoa8Nnimq5teqA9Jvn31285SDdFGy9oekCKxlgt9US9oQ6fvXH-RWo70BTs6HDDBDlOVMY33NgQU5ZQH2hE7YcuL84OGQwoU49DihvVDTqrvZI6YaDj5Hyw1A4GdbJ-OCCfjXQRD9_nnPz8cn1_dVPcfft6e3V5V-gKoCwa0cGiFlwJFFIxI7hBrBWoSvGGdbUyC1wAoOZSIWDViYqDMA3kDwNe8zk52XrH4J9WGFPb26jROTmgX8WW1dDAoqnyjTk53aI6-BgDmnYMtpdhahm0myBtDtK-Bcns8bt2pXrs_pEfBTJwvgXW1uH0f1N7-f1-q3wF3LObvQ</recordid><startdate>201609</startdate><enddate>201609</enddate><creator>Chen, P.‐Y.</creator><creator>Wu, M.‐S.</creator><creator>Chen, C.‐Y.</creator><creator>Bair, M.‐J.</creator><creator>Chou, C.‐K.</creator><creator>Lin, J.‐T.</creator><creator>Liou, J.‐M.</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201609</creationdate><title>Systematic review with meta‐analysis: the efficacy of levofloxacin triple therapy as the first‐ or second‐line treatments of Helicobacter pylori infection</title><author>Chen, P.‐Y. ; Wu, M.‐S. ; Chen, C.‐Y. ; Bair, M.‐J. ; Chou, C.‐K. ; Lin, J.‐T. ; Liou, J.‐M.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c5002-96d04863b6e6ab1f63fee8b0b5b391d8bf4e400ec3abe0e5d65306f90d6510383</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Adult</topic><topic>Amoxicillin - administration & dosage</topic><topic>Anti-Bacterial Agents - administration & dosage</topic><topic>Clinical Trials as Topic - methods</topic><topic>Databases, Factual</topic><topic>Drug Resistance, Bacterial</topic><topic>Drug Therapy, Combination</topic><topic>Helicobacter Infections - diagnosis</topic><topic>Helicobacter Infections - drug therapy</topic><topic>Helicobacter pylori - drug effects</topic><topic>Helicobacter pylori - physiology</topic><topic>Humans</topic><topic>Levofloxacin - administration & dosage</topic><topic>Prospective Studies</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Chen, P.‐Y.</creatorcontrib><creatorcontrib>Wu, M.‐S.</creatorcontrib><creatorcontrib>Chen, C.‐Y.</creatorcontrib><creatorcontrib>Bair, M.‐J.</creatorcontrib><creatorcontrib>Chou, C.‐K.</creatorcontrib><creatorcontrib>Lin, J.‐T.</creatorcontrib><creatorcontrib>Liou, J.‐M.</creatorcontrib><creatorcontrib>Taiwan Gastrointestinal Disease and Helicobacter Consortium</creatorcontrib><creatorcontrib>for the Taiwan Gastrointestinal Disease and Helicobacter Consortium</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Alimentary pharmacology & therapeutics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Chen, P.‐Y.</au><au>Wu, M.‐S.</au><au>Chen, C.‐Y.</au><au>Bair, M.‐J.</au><au>Chou, C.‐K.</au><au>Lin, J.‐T.</au><au>Liou, J.‐M.</au><aucorp>Taiwan Gastrointestinal Disease and Helicobacter Consortium</aucorp><aucorp>for the Taiwan Gastrointestinal Disease and Helicobacter Consortium</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Systematic review with meta‐analysis: the efficacy of levofloxacin triple therapy as the first‐ or second‐line treatments of Helicobacter pylori infection</atitle><jtitle>Alimentary pharmacology & therapeutics</jtitle><addtitle>Aliment Pharmacol Ther</addtitle><date>2016-09</date><risdate>2016</risdate><volume>44</volume><issue>5</issue><spage>427</spage><epage>437</epage><pages>427-437</pages><issn>0269-2813</issn><eissn>1365-2036</eissn><notes>SourceType-Scholarly Journals-1</notes><notes>ObjectType-Feature-2</notes><notes>content type line 23</notes><notes>ObjectType-Review-1</notes><notes>ObjectType-Article-3</notes><notes>ObjectType-Undefined-4</notes><abstract>Summary
Background
Levofloxacin triple therapy has been used for the first‐line and second‐line treatment of Helicobacter pylori infection for more than 10 years.
Aims
To systematically review the efficacy of levofloxacin triple therapy in the first‐ and second‐line treatment, and to assess the time trend and factors that might affect its efficacy.
Methods
Prospective trials reporting the efficacy of levofloxacin triple therapy in either the first‐line or second‐line treatment of H. pylori infection in adults were searched from the PubMed and Cochrane database from January 2000 to September 2015. Meta‐analysis was performed to calculate the cumulative eradication rate and the efficacies in subgroups.
Results
Of the 322 articles identified, a total of 4574 patients from 41 trials, including 16 trials in the first‐line treatment and 25 trials in the second‐line treatment were eligible for analysis. The cumulative eradication rate was 77.3% (95% confidence intervals, CI: 74.7–79.6) and was 80.7% (95% CI 77.1–83.7) in the first‐line treatment and 74.5% (95% CI: 70.9–77.8) in the second‐line treatment. The efficacies of levofloxacin triple therapy before 2008, between 2009 and 2011, and after 2012 were 77.4%, 79.6% and 74.8% respectively. The eradication rate was higher when levofloxacin was given once daily (80.6%, 95% CI: 77.1–83.7) than twice daily (73.6%, 95% CI: 69.7–77.2). The efficacy was significantly higher in levofloxacin‐susceptible strains than resistant strains (81.1% vs. 36.3%, risk ratio 2.18, 95% CI: 1.6–3, P < 0.001).
Conclusion
The efficacy of levofloxacin triple therapy has been lower than 80% in many countries and it is not recommended when the levofloxacin resistance is higher than 5–10%.</abstract><cop>England</cop><pmid>27363687</pmid><doi>10.1111/apt.13712</doi><tpages>11</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Alimentary pharmacology & therapeutics, 2016-09, Vol.44 (5), p.427-437 |
| issn | 0269-2813 1365-2036 |
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| source | Wiley |
| subjects | Adult Amoxicillin - administration & dosage Anti-Bacterial Agents - administration & dosage Clinical Trials as Topic - methods Databases, Factual Drug Resistance, Bacterial Drug Therapy, Combination Helicobacter Infections - diagnosis Helicobacter Infections - drug therapy Helicobacter pylori - drug effects Helicobacter pylori - physiology Humans Levofloxacin - administration & dosage Prospective Studies Treatment Outcome |
| title | Systematic review with meta‐analysis: the efficacy of levofloxacin triple therapy as the first‐ or second‐line treatments of Helicobacter pylori infection |
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