Second-line rescue treatment of infection: Where are we now?

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Term Occurence Count Dictionary
amoxicillin 42 infectiousdiseasesdrugs
clarithromycin 11 infectiousdiseasesdrugs
levofloxacin 41 infectiousdiseasesdrugs
metronidazole 12 infectiousdiseasesdrugs
ofloxacin 46 infectiousdiseasesdrugs
tetracycline 11 infectiousdiseasesdrugs

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amoxicillin 752 The Maastricht V/Florence Consensus Report recommends bismuth quadruple therapy, or fluoroquinolone- amoxicillin triple/quadruple therapy as the second-line therapy for H. pylori infection. Meta-analyses have shown
amoxicillin 914 therapy for H. pylori infection. Meta-analyses have shown that bismuth quadruple therapy and levofloxacin- amoxicillin triple therapy have comparable eradication rates, while the former has more adverse effects than the
amoxicillin 1118 than the latter. There are no significant differences between the eradication rates of levofloxacin- amoxicillin triple and quadruple therapies. However, the eradication rates of both levofloxacin-containing treatments
amoxicillin 1288 rates of both levofloxacin-containing treatments are suboptimal. An important caveat of levofloxacin- amoxicillin triple or quadruple therapy is poor eradication efficacy in the presence of fluoroquinolone resistance.
amoxicillin 1523 therapy is an emerging second-line therapy and has an eradication efficacy comparable with levofloxacin- amoxicillin triple therapy. Recently, a 10-d tetracycline-levofloxacin (TL) quadruple therapy comprised of a proton
amoxicillin 1791 levofloxacin has been developed, which achieves a markedly higher eradication rate compared with levofloxacin- amoxicillin triple therapy (98% vs 69%) in patients with failure of standard triple, bismuth quadruple or non-bismuth
amoxicillin 2080 anti-H. pylori regimens and treatment algorisms. In conclusion, bismuth quadruple therapy, levofloxacin- amoxicillin triple/quadruple therapy, high-dose dual therapy and TL quadruple therapy can be used as second-line
amoxicillin 2622 second-line anti-Helicobacter pylori (H. pylori) regimens. Bismuth quadruple therapy and levofloxacin- amoxicillin triple therapy have comparable eradication rates in the rescue treatment of H. pylori infection, while
amoxicillin 2866 effects than the latter. High-dose dual therapy has an eradication rate comparable with levofloxacin- amoxicillin triple therapy. Ten-day tetracycline-levofloxacin quadruple therapy achieves a markedly higher eradication
amoxicillin 3017 tetracycline-levofloxacin quadruple therapy achieves a markedly higher eradication rate compared with levofloxacin- amoxicillin triple therapy (98% vs 69%) in patients with failure of standard triple, bismuth quadruple or non-bismuth
amoxicillin 4543 the main factor which determines the efficacy of an eradication therapy[[8]]. Primary resistance to amoxicillin is either null or < 1% in most countries[[9]]. In contrast, the rate of primary clarithromycin-resistance
amoxicillin 5479 standard triple therapy, the rates of drug resistance to clarithromycin, metronidazole, levofloxacin, amoxicillin and tetracycline are 65%-75%, 30%-56%, 26%-37%, 0%-6.1% and 0%-10%, respectively[[12]-[16]]. Whereas
amoxicillin 5739 non-bismuth quadruple therapy, the rates of drug resistance to clarithromycin, metronidazole, levofloxacin, amoxicillin and tetracycline are 75%, 75%, 25%, 0%, and 0%, respectively[[17],[18]]. This data implies that amoxicillin,
amoxicillin 5847 amoxicillin and tetracycline are 75%, 75%, 25%, 0%, and 0%, respectively[[17],[18]]. This data implies that amoxicillin , tetracycline and levofloxacin are good choices of antibiotics for rescue treatment of H. pylori infection.Point
amoxicillin 6893 SECOND-LINE THERAPIESCurrent updated second-line therapies include bismuth quadruple therapy, fluoroquinolone- amoxicillin triple therapy, fluoroquinolone-amoxicillin quadruple therapy, tetracycline-levofloxacin (TL) quadruple
amoxicillin 6937 therapies include bismuth quadruple therapy, fluoroquinolone-amoxicillin triple therapy, fluoroquinolone- amoxicillin quadruple therapy, tetracycline-levofloxacin (TL) quadruple therapy and high-dose dual therapy.Bismuth
amoxicillin 8381 t.i.d.10-14 dLevofloxacin-containing triple therapySD, b.i.d.500 mg, q.d.1 g, b.i.d.10-14 dLevofloxacin- amoxicillin quadruple therapySD, b.i.d.120 mg, q.i.d.500 mg, q.d.1 g, b.i.d.10-14 dTetracycline-levofloxacin quadruple
amoxicillin 8868 therapyThe most commonly used fluoroquinolone-based triple therapy is composed of levofloxacin 500 mg daily, amoxicillin 1 g twice daily and a PPI (standard dose) twice daily for 10 to 14 d (Table 1). Meta-analyses revealed
amoxicillin 9001 PPI (standard dose) twice daily for 10 to 14 d (Table 1). Meta-analyses revealed that levofloxacin- amoxicillin triple therapy and bismuth quadruple therapy had comparable eradication rates, whereas the former had
amoxicillin 9223 adverse effects than the latter[[30]]. A systemic review and meta-analysis revealed that levofloxacin- amoxicillin triple therapy achieved an overall eradication rate of 78% after failure of a non-bismuth quadruple
amoxicillin 9493 sequential and concomitant therapies (81% vs 78%, respectively), and the cure rate of levofloxacin- amoxicillin triple therapy following hybrid therapy was 50%.An important drawback of levofloxacin-amoxicillin triple
amoxicillin 9591 levofloxacin-amoxicillin triple therapy following hybrid therapy was 50%.An important drawback of levofloxacin- amoxicillin triple therapy is poor eradication efficacy in the presence of fluoroquinolone resistance. Bismuth salts
amoxicillin 9900 rates[[32]]. The Maastricht V/Florence Consensus Report also recommended the application of fluoroquinolone- amoxicillin quadruple therapy as a second-line therapy for H. pylori infection[[31]]. Levofloxacin-amoxicillin quadruple
amoxicillin 9999 fluoroquinolone-amoxicillin quadruple therapy as a second-line therapy for H. pylori infection[[31]]. Levofloxacin- amoxicillin quadruple therapy is composed of levofloxacin 500 mg daily, amoxicillin 1 g twice daily, PPI (standard
amoxicillin 10071 infection[[31]]. Levofloxacin-amoxicillin quadruple therapy is composed of levofloxacin 500 mg daily, amoxicillin 1 g twice daily, PPI (standard dose) twice daily and bismuth 240 mg twice daily for 10 to 14 d (Table
amoxicillin 10327 there were no significant differences between the eradication rates of second-line 14-d levofloxacin- amoxicillin quadruple therapy and 14-d levofloxacin-amoxicillin triple therapy (87% vs 83%, respectively)[[33]].
amoxicillin 10379 eradication rates of second-line 14-d levofloxacin-amoxicillin quadruple therapy and 14-d levofloxacin- amoxicillin triple therapy (87% vs 83%, respectively)[[33]]. However, the former had a higher eradication rate for
amoxicillin 11225 much higher eradication rate compared with 10-d levofloxacin triple therapy containing esomeprazole, amoxicillin and levofloxacin (98% vs 68%, respectively)[[34]]. Subgroup analysis revealed that the former was superior
amoxicillin 11650 failure by bismuth quadruple therapy as a first-line treatment, and both TL quadruple and levofloxacin- amoxicillin triple therapies had a 100% eradication rate in this subgroup of patients. The data suggests that 10-d
amoxicillin 12071 second-line treatment for H. pylori infection[[35]]. The new therapy consists of high-dose PPI and amoxicillin (Table 1), which keep the intragastric pH higher than 6.5 regardless of CYP2C19 genotype[[36]], and
amoxicillin 12225 higher than 6.5 regardless of CYP2C19 genotype[[36]], and maintain a steady plasma concentration of amoxicillin above the minimal inhibitory concentration for H. pylori[[37]]. A randomized control trial from Taiwan
amoxicillin 12572 for H. pylori infection (89% vs 52%), and had an eradication rate comparable with 7-d levofloxacin- amoxicillin triple therapy (79%)[[35]]. Another randomized controlled trial from Germany demonstrated that 14-d
amoxicillin 13805 regimen also depends on regional factors. In Japan, PPI-containing triple therapy with metronidazole and amoxicillin is the standard second line regimen and is covered under Japan’s national health insurance. This second-line
amoxicillin 14256 bismuth-containing quadruple therapy, fluoroquinolone-containing triple therapy or fluoroquinolone- amoxicillin quadruple therapy are recommended following failure of standard triple therapy. As TL quadruple therapy
amoxicillin 14520 levofloxacin triple therapy, and high-dose dual therapy has a comparable eradication rate with levofloxacin- amoxicillin triple therapy in patients with failure of standard triple therapy[[34],[35]], both TL quadruple and
amoxicillin 15025 therapyThe Maastricht V/Florence Consensus Report recommends bismuth quadruple therapy, levofloxacin- amoxicillin triple therapy and levofloxacin-amoxicillin quadruple therapy as rescue treatments after failure of
amoxicillin 15069 Report recommends bismuth quadruple therapy, levofloxacin-amoxicillin triple therapy and levofloxacin- amoxicillin quadruple therapy as rescue treatments after failure of a non-bismuth quadruple therapy[[31]]. As 10-d
amoxicillin 15238 non-bismuth quadruple therapy[[31]]. As 10-d TL quadruple therapy is superior to 10-d levofloxacin- amoxicillin triple therapy, it is reasonable to recommend TL-quadruple therapy as the rescue treatment for patients
amoxicillin 15583 Maastricht V/Florence Consensus Report[[31]], fluoroquinolone-containing triple or fluoroquinolone- amoxicillin quadruple therapy can be recommended for patients with eradication failure by bismuth quadruple therapy
amoxicillin 15762 failure by bismuth quadruple therapy for H. pylori infection. As both TL quadruple and levofloxacin- amoxicillin triple therapies achieved a 100% cure rate in this setting. TL quadruple therapy may also be considered
amoxicillin 16059 1).CONCLUSIONThe current updated second-line therapies include bismuth quadruple therapy, fluoroquinolone- amoxicillin triple therapy, fluoroquinolone-amoxicillin quadruple therapy, TL quadruple therapy and high-dose dual
amoxicillin 16103 therapies include bismuth quadruple therapy, fluoroquinolone-amoxicillin triple therapy, fluoroquinolone- amoxicillin quadruple therapy, TL quadruple therapy and high-dose dual therapy. Ten-day TL quadruple therapy has
clarithromycin 4635 resistance to amoxicillin is either null or < 1% in most countries[[9]]. In contrast, the rate of primary clarithromycin -resistance ranges from 49% (Spain) to 1% (the Netherlands) worldwide[[10]]. High primary resistance
clarithromycin 4753 clarithromycin-resistance ranges from 49% (Spain) to 1% (the Netherlands) worldwide[[10]]. High primary resistance to clarithromycin and low resistance to metronidazole have been observed in Japan; moderate resistance to clarithromycin
clarithromycin 4856 clarithromycin and low resistance to metronidazole have been observed in Japan; moderate resistance to clarithromycin and high resistance to metronidazole were reported in South Korea; and high primary resistance to both
clarithromycin 4974 high resistance to metronidazole were reported in South Korea; and high primary resistance to both clarithromycin and metronidazole was observed in China[[11]]. High primary resistance to both clarithromycin and metronidazole
clarithromycin 5068 both clarithromycin and metronidazole was observed in China[[11]]. High primary resistance to both clarithromycin and metronidazole has also been reported in some other countries, such as Italy, Spain, Mexico and Vietnam.
clarithromycin 5195 metronidazole has also been reported in some other countries, such as Italy, Spain, Mexico and Vietnam. Low clarithromycin resistance is generally observed in northern Europe, including the Netherlands, Sweden and Ireland[[10],[11]].In
clarithromycin 5434 who experience eradication failure following standard triple therapy, the rates of drug resistance to clarithromycin , metronidazole, levofloxacin, amoxicillin and tetracycline are 65%-75%, 30%-56%, 26%-37%, 0%-6.1% and
clarithromycin 5694 for patients who experience failure of non-bismuth quadruple therapy, the rates of drug resistance to clarithromycin , metronidazole, levofloxacin, amoxicillin and tetracycline are 75%, 75%, 25%, 0%, and 0%, respectively[[17],[18]].
clarithromycin 6173 involving the rdxA gene have been identified in metronidazole resistant strains[[19]]. Resistance to clarithromycin in H. pylori is commonly caused by point mutations in the rrl gene encoding two 23S rRNA nucleotides,
clarithromycin 6371 rRNA nucleotides, namely 2142 and 2143[[20]]. Another mechanism associated with the development of clarithromycin resistance is the efflux pump system[[21],[22]]. Fluoroquinolone acts on the site of the type A DNA
clarithromycin 7780 of randomized controlled trials of bismuth quadruple therapy as a rescue treatment after failure of clarithromycin triple therapy revealed a significantly higher eradication rate for the 14-d regimen compared with the
levofloxacin 901 second-line therapy for H. pylori infection. Meta-analyses have shown that bismuth quadruple therapy and levofloxacin -amoxicillin triple therapy have comparable eradication rates, while the former has more adverse effects
levofloxacin 1105 adverse effects than the latter. There are no significant differences between the eradication rates of levofloxacin -amoxicillin triple and quadruple therapies. However, the eradication rates of both levofloxacin-containing
levofloxacin 1201 of levofloxacin-amoxicillin triple and quadruple therapies. However, the eradication rates of both levofloxacin -containing treatments are suboptimal. An important caveat of levofloxacin-amoxicillin triple or quadruple
levofloxacin 1275 eradication rates of both levofloxacin-containing treatments are suboptimal. An important caveat of levofloxacin -amoxicillin triple or quadruple therapy is poor eradication efficacy in the presence of fluoroquinolone
levofloxacin 1510 High-dose dual therapy is an emerging second-line therapy and has an eradication efficacy comparable with levofloxacin -amoxicillin triple therapy. Recently, a 10-d tetracycline-levofloxacin (TL) quadruple therapy comprised
levofloxacin 1581 eradication efficacy comparable with levofloxacin-amoxicillin triple therapy. Recently, a 10-d tetracycline- levofloxacin (TL) quadruple therapy comprised of a proton pump inhibitor, bismuth, tetracycline and levofloxacin
levofloxacin 1681 tetracycline-levofloxacin (TL) quadruple therapy comprised of a proton pump inhibitor, bismuth, tetracycline and levofloxacin has been developed, which achieves a markedly higher eradication rate compared with levofloxacin-amoxicillin
levofloxacin 1778 and levofloxacin has been developed, which achieves a markedly higher eradication rate compared with levofloxacin -amoxicillin triple therapy (98% vs 69%) in patients with failure of standard triple, bismuth quadruple
levofloxacin 2067 second-line anti-H. pylori regimens and treatment algorisms. In conclusion, bismuth quadruple therapy, levofloxacin -amoxicillin triple/quadruple therapy, high-dose dual therapy and TL quadruple therapy can be used as
levofloxacin 2609 reviews current second-line anti-Helicobacter pylori (H. pylori) regimens. Bismuth quadruple therapy and levofloxacin -amoxicillin triple therapy have comparable eradication rates in the rescue treatment of H. pylori infection,
levofloxacin 2853 more adverse effects than the latter. High-dose dual therapy has an eradication rate comparable with levofloxacin -amoxicillin triple therapy. Ten-day tetracycline-levofloxacin quadruple therapy achieves a markedly
levofloxacin 2915 has an eradication rate comparable with levofloxacin-amoxicillin triple therapy. Ten-day tetracycline- levofloxacin quadruple therapy achieves a markedly higher eradication rate compared with levofloxacin-amoxicillin
levofloxacin 3004 tetracycline-levofloxacin quadruple therapy achieves a markedly higher eradication rate compared with levofloxacin -amoxicillin triple therapy (98% vs 69%) in patients with failure of standard triple, bismuth quadruple
levofloxacin 3182 of standard triple, bismuth quadruple or non-bismuth quadruple therapy. In conclusion, tetracycline- levofloxacin quadruple therapy has the potential to become a universal second-line treatment for H. pylori infection.INTRODUCTIONHelicobacter
levofloxacin 5465 failure following standard triple therapy, the rates of drug resistance to clarithromycin, metronidazole, levofloxacin , amoxicillin and tetracycline are 65%-75%, 30%-56%, 26%-37%, 0%-6.1% and 0%-10%, respectively[[12]-[16]].
levofloxacin 5725 failure of non-bismuth quadruple therapy, the rates of drug resistance to clarithromycin, metronidazole, levofloxacin , amoxicillin and tetracycline are 75%, 75%, 25%, 0%, and 0%, respectively[[17],[18]]. This data implies
levofloxacin 5877 75%, 25%, 0%, and 0%, respectively[[17],[18]]. This data implies that amoxicillin, tetracycline and levofloxacin are good choices of antibiotics for rescue treatment of H. pylori infection.Point mutations play a primary
levofloxacin 6981 fluoroquinolone-amoxicillin triple therapy, fluoroquinolone-amoxicillin quadruple therapy, tetracycline- levofloxacin (TL) quadruple therapy and high-dose dual therapy.Bismuth quadruple therapyBismuth quadruple therapy
levofloxacin 8477 dLevofloxacin-amoxicillin quadruple therapySD, b.i.d.120 mg, q.i.d.500 mg, q.d.1 g, b.i.d.10-14 dTetracycline- levofloxacin quadruple therapySD, b.i.d.120 mg, q.i.d.500 mg, q.d.500 mg, q.i.d.10 dHigh-dose dual therapySD, q.i.d.750
levofloxacin 8841 triple/quadruple therapyThe most commonly used fluoroquinolone-based triple therapy is composed of levofloxacin 500 mg daily, amoxicillin 1 g twice daily and a PPI (standard dose) twice daily for 10 to 14 d (Table
levofloxacin 8988 twice daily and a PPI (standard dose) twice daily for 10 to 14 d (Table 1). Meta-analyses revealed that levofloxacin -amoxicillin triple therapy and bismuth quadruple therapy had comparable eradication rates, whereas the
levofloxacin 9210 had fewer adverse effects than the latter[[30]]. A systemic review and meta-analysis revealed that levofloxacin -amoxicillin triple therapy achieved an overall eradication rate of 78% after failure of a non-bismuth
levofloxacin 9480 after failure of sequential and concomitant therapies (81% vs 78%, respectively), and the cure rate of levofloxacin -amoxicillin triple therapy following hybrid therapy was 50%.An important drawback of levofloxacin-amoxicillin
levofloxacin 9578 of levofloxacin-amoxicillin triple therapy following hybrid therapy was 50%.An important drawback of levofloxacin -amoxicillin triple therapy is poor eradication efficacy in the presence of fluoroquinolone resistance.
levofloxacin 10044 second-line therapy for H. pylori infection[[31]]. Levofloxacin-amoxicillin quadruple therapy is composed of levofloxacin 500 mg daily, amoxicillin 1 g twice daily, PPI (standard dose) twice daily and bismuth 240 mg twice
levofloxacin 10314 trial showed there were no significant differences between the eradication rates of second-line 14-d levofloxacin -amoxicillin quadruple therapy and 14-d levofloxacin-amoxicillin triple therapy (87% vs 83%, respectively)[[33]].
levofloxacin 10366 between the eradication rates of second-line 14-d levofloxacin-amoxicillin quadruple therapy and 14-d levofloxacin -amoxicillin triple therapy (87% vs 83%, respectively)[[33]]. However, the former had a higher eradication
levofloxacin 10494 triple therapy (87% vs 83%, respectively)[[33]]. However, the former had a higher eradication rate for levofloxacin -resistant strains than the latter (71% vs 37%)[[33]].TL quadruple therapyRecently, Hsu et al[[17]] developed
levofloxacin 10840 tripotassium dicitrato bismuthate 120 mg four times daily, tetracycline 500 mg four times daily, and levofloxacin 500 mg once daily for 10 d (Table 1). The simple regimen maintains a high eradication rate for H. pylori
levofloxacin 10971 for 10 d (Table 1). The simple regimen maintains a high eradication rate for H. pylori strains with levofloxacin resistance[[17]]. A randomized control study showed that as a second-line anti-H. pylori treatment,
levofloxacin 11172 treatment, 10-d of TL quadruple therapy achieved a much higher eradication rate compared with 10-d levofloxacin triple therapy containing esomeprazole, amoxicillin and levofloxacin (98% vs 68%, respectively)[[34]].
levofloxacin 11241 eradication rate compared with 10-d levofloxacin triple therapy containing esomeprazole, amoxicillin and levofloxacin (98% vs 68%, respectively)[[34]]. Subgroup analysis revealed that the former was superior to the latter
levofloxacin 11637 eradication failure by bismuth quadruple therapy as a first-line treatment, and both TL quadruple and levofloxacin -amoxicillin triple therapies had a 100% eradication rate in this subgroup of patients. The data suggests
levofloxacin 12559 second-line treatment for H. pylori infection (89% vs 52%), and had an eradication rate comparable with 7-d levofloxacin -amoxicillin triple therapy (79%)[[35]]. Another randomized controlled trial from Germany demonstrated
levofloxacin 13627 novel 10-d TL quadruple regimen can maintain a high eradication rate (> 90%) for H. pylori strains with levofloxacin resistance[[34]]. However, the choice of second line rescue regimen also depends on regional factors.
levofloxacin 14412 failure of standard triple therapy. As TL quadruple therapy achieves a higher eradication rate than levofloxacin triple therapy, and high-dose dual therapy has a comparable eradication rate with levofloxacin-amoxicillin
levofloxacin 14507 than levofloxacin triple therapy, and high-dose dual therapy has a comparable eradication rate with levofloxacin -amoxicillin triple therapy in patients with failure of standard triple therapy[[34],[35]], both TL quadruple
levofloxacin 15012 non-bismuth quadruple therapyThe Maastricht V/Florence Consensus Report recommends bismuth quadruple therapy, levofloxacin -amoxicillin triple therapy and levofloxacin-amoxicillin quadruple therapy as rescue treatments after
levofloxacin 15056 Consensus Report recommends bismuth quadruple therapy, levofloxacin-amoxicillin triple therapy and levofloxacin -amoxicillin quadruple therapy as rescue treatments after failure of a non-bismuth quadruple therapy[[31]].
levofloxacin 15225 failure of a non-bismuth quadruple therapy[[31]]. As 10-d TL quadruple therapy is superior to 10-d levofloxacin -amoxicillin triple therapy, it is reasonable to recommend TL-quadruple therapy as the rescue treatment
levofloxacin 15749 eradication failure by bismuth quadruple therapy for H. pylori infection. As both TL quadruple and levofloxacin -amoxicillin triple therapies achieved a 100% cure rate in this setting. TL quadruple therapy may also
metronidazole 4790 (the Netherlands) worldwide[[10]]. High primary resistance to clarithromycin and low resistance to metronidazole have been observed in Japan; moderate resistance to clarithromycin and high resistance to metronidazole
metronidazole 4894 metronidazole have been observed in Japan; moderate resistance to clarithromycin and high resistance to metronidazole were reported in South Korea; and high primary resistance to both clarithromycin and metronidazole was
metronidazole 4993 metronidazole were reported in South Korea; and high primary resistance to both clarithromycin and metronidazole was observed in China[[11]]. High primary resistance to both clarithromycin and metronidazole has also
metronidazole 5087 clarithromycin and metronidazole was observed in China[[11]]. High primary resistance to both clarithromycin and metronidazole has also been reported in some other countries, such as Italy, Spain, Mexico and Vietnam. Low clarithromycin
metronidazole 5450 eradication failure following standard triple therapy, the rates of drug resistance to clarithromycin, metronidazole , levofloxacin, amoxicillin and tetracycline are 65%-75%, 30%-56%, 26%-37%, 0%-6.1% and 0%-10%, respectively[[12]-[16]].
metronidazole 5710 experience failure of non-bismuth quadruple therapy, the rates of drug resistance to clarithromycin, metronidazole , levofloxacin, amoxicillin and tetracycline are 75%, 75%, 25%, 0%, and 0%, respectively[[17],[18]].
metronidazole 6120 antimicrobial resistance of H. pylori, and different mutations involving the rdxA gene have been identified in metronidazole resistant strains[[19]]. Resistance to clarithromycin in H. pylori is commonly caused by point mutations
metronidazole 7147 therapy.Bismuth quadruple therapyBismuth quadruple therapy consists of a proton pump inhibitor (PPI), bismuth, metronidazole and tetracycline (Table 1). The standard regimen comprises PPI twice daily, colloidal bismuth subcitrate
metronidazole 7332 daily, colloidal bismuth subcitrate 120 mg four times daily, tetracycline 500 mg four times daily and metronidazole 500 mg three times daily for 10 to 14 d. A pool analysis demonstrated that bismuth quadruple therapy
metronidazole 7580 second-line therapy and achieves a mean 76% eradication rate[[25]-[27]]. Its efficacy is related to metronidazole resistance in H. pylori strains and the duration of the regimens[[28]]. Meta-analysis of randomized
metronidazole 13787 line rescue regimen also depends on regional factors. In Japan, PPI-containing triple therapy with metronidazole and amoxicillin is the standard second line regimen and is covered under Japan’s national health insurance.
metronidazole 13995 health insurance. This second-line therapy can also achieve an eradication rate of around 90% because metronidazole resistance rate is relatively low in Japan.After failure of a standard triple therapyAccording to the
ofloxacin 904 second-line therapy for H. pylori infection. Meta-analyses have shown that bismuth quadruple therapy and lev ofloxacin -amoxicillin triple therapy have comparable eradication rates, while the former has more adverse effects
ofloxacin 1108 adverse effects than the latter. There are no significant differences between the eradication rates of lev ofloxacin -amoxicillin triple and quadruple therapies. However, the eradication rates of both levofloxacin-containing
ofloxacin 1204 levofloxacin-amoxicillin triple and quadruple therapies. However, the eradication rates of both lev ofloxacin -containing treatments are suboptimal. An important caveat of levofloxacin-amoxicillin triple or quadruple
ofloxacin 1278 eradication rates of both levofloxacin-containing treatments are suboptimal. An important caveat of lev ofloxacin -amoxicillin triple or quadruple therapy is poor eradication efficacy in the presence of fluoroquinolone
ofloxacin 1513 dual therapy is an emerging second-line therapy and has an eradication efficacy comparable with lev ofloxacin -amoxicillin triple therapy. Recently, a 10-d tetracycline-levofloxacin (TL) quadruple therapy comprised
ofloxacin 1584 efficacy comparable with levofloxacin-amoxicillin triple therapy. Recently, a 10-d tetracycline-lev ofloxacin (TL) quadruple therapy comprised of a proton pump inhibitor, bismuth, tetracycline and levofloxacin
ofloxacin 1684 tetracycline-levofloxacin (TL) quadruple therapy comprised of a proton pump inhibitor, bismuth, tetracycline and lev ofloxacin has been developed, which achieves a markedly higher eradication rate compared with levofloxacin-amoxicillin
ofloxacin 1781 levofloxacin has been developed, which achieves a markedly higher eradication rate compared with lev ofloxacin -amoxicillin triple therapy (98% vs 69%) in patients with failure of standard triple, bismuth quadruple
ofloxacin 2070 second-line anti-H. pylori regimens and treatment algorisms. In conclusion, bismuth quadruple therapy, lev ofloxacin -amoxicillin triple/quadruple therapy, high-dose dual therapy and TL quadruple therapy can be used as
ofloxacin 2612 current second-line anti-Helicobacter pylori (H. pylori) regimens. Bismuth quadruple therapy and lev ofloxacin -amoxicillin triple therapy have comparable eradication rates in the rescue treatment of H. pylori infection,
ofloxacin 2856 adverse effects than the latter. High-dose dual therapy has an eradication rate comparable with lev ofloxacin -amoxicillin triple therapy. Ten-day tetracycline-levofloxacin quadruple therapy achieves a markedly
ofloxacin 2918 an eradication rate comparable with levofloxacin-amoxicillin triple therapy. Ten-day tetracycline-lev ofloxacin quadruple therapy achieves a markedly higher eradication rate compared with levofloxacin-amoxicillin
ofloxacin 3007 tetracycline-levofloxacin quadruple therapy achieves a markedly higher eradication rate compared with lev ofloxacin -amoxicillin triple therapy (98% vs 69%) in patients with failure of standard triple, bismuth quadruple
ofloxacin 3185 standard triple, bismuth quadruple or non-bismuth quadruple therapy. In conclusion, tetracycline-lev ofloxacin quadruple therapy has the potential to become a universal second-line treatment for H. pylori infection.INTRODUCTIONHelicobacter
ofloxacin 5468 following standard triple therapy, the rates of drug resistance to clarithromycin, metronidazole, lev ofloxacin , amoxicillin and tetracycline are 65%-75%, 30%-56%, 26%-37%, 0%-6.1% and 0%-10%, respectively[[12]-[16]].
ofloxacin 5728 of non-bismuth quadruple therapy, the rates of drug resistance to clarithromycin, metronidazole, lev ofloxacin , amoxicillin and tetracycline are 75%, 75%, 25%, 0%, and 0%, respectively[[17],[18]]. This data implies
ofloxacin 5880 75%, 25%, 0%, and 0%, respectively[[17],[18]]. This data implies that amoxicillin, tetracycline and lev ofloxacin are good choices of antibiotics for rescue treatment of H. pylori infection.Point mutations play a primary
ofloxacin 6984 fluoroquinolone-amoxicillin triple therapy, fluoroquinolone-amoxicillin quadruple therapy, tetracycline-lev ofloxacin (TL) quadruple therapy and high-dose dual therapy.Bismuth quadruple therapyBismuth quadruple therapy
ofloxacin 8293 therapyPPIBismuthLevoAmoxTetraMetroBismuth-containing quadruple therapySD, b.i.d.120 mg, q.i.d.500 mg, q.i.d.500 mg, t.i.d.10-14 dLev ofloxacin -containing triple therapySD, b.i.d.500 mg, q.d.1 g, b.i.d.10-14 dLevofloxacin-amoxicillin quadruple
ofloxacin 8371 q.i.d.500 mg, t.i.d.10-14 dLevofloxacin-containing triple therapySD, b.i.d.500 mg, q.d.1 g, b.i.d.10-14 dLev ofloxacin -amoxicillin quadruple therapySD, b.i.d.120 mg, q.i.d.500 mg, q.d.1 g, b.i.d.10-14 dTetracycline-levofloxacin
ofloxacin 8480 dLevofloxacin-amoxicillin quadruple therapySD, b.i.d.120 mg, q.i.d.500 mg, q.d.1 g, b.i.d.10-14 dTetracycline-lev ofloxacin quadruple therapySD, b.i.d.120 mg, q.i.d.500 mg, q.d.500 mg, q.i.d.10 dHigh-dose dual therapySD, q.i.d.750
ofloxacin 8648 mg, q.i.d.10 dHigh-dose dual therapySD, q.i.d.750 mg, b.i.d.14 dPPI: Proton pump inhibitor; Levo: Lev ofloxacin ; Amox: Amoxicillin; Tetra: Tetracycline; Metro: Metronidazole.Fluoroquinolone-based triple/quadruple
ofloxacin 8844 triple/quadruple therapyThe most commonly used fluoroquinolone-based triple therapy is composed of lev ofloxacin 500 mg daily, amoxicillin 1 g twice daily and a PPI (standard dose) twice daily for 10 to 14 d (Table
ofloxacin 8991 daily and a PPI (standard dose) twice daily for 10 to 14 d (Table 1). Meta-analyses revealed that lev ofloxacin -amoxicillin triple therapy and bismuth quadruple therapy had comparable eradication rates, whereas the
ofloxacin 9213 had fewer adverse effects than the latter[[30]]. A systemic review and meta-analysis revealed that lev ofloxacin -amoxicillin triple therapy achieved an overall eradication rate of 78% after failure of a non-bismuth
ofloxacin 9483 failure of sequential and concomitant therapies (81% vs 78%, respectively), and the cure rate of lev ofloxacin -amoxicillin triple therapy following hybrid therapy was 50%.An important drawback of levofloxacin-amoxicillin
ofloxacin 9581 levofloxacin-amoxicillin triple therapy following hybrid therapy was 50%.An important drawback of lev ofloxacin -amoxicillin triple therapy is poor eradication efficacy in the presence of fluoroquinolone resistance.
ofloxacin 9989 fluoroquinolone-amoxicillin quadruple therapy as a second-line therapy for H. pylori infection[[31]]. Lev ofloxacin -amoxicillin quadruple therapy is composed of levofloxacin 500 mg daily, amoxicillin 1 g twice daily,
ofloxacin 10047 therapy for H. pylori infection[[31]]. Levofloxacin-amoxicillin quadruple therapy is composed of lev ofloxacin 500 mg daily, amoxicillin 1 g twice daily, PPI (standard dose) twice daily and bismuth 240 mg twice
ofloxacin 10317 trial showed there were no significant differences between the eradication rates of second-line 14-d lev ofloxacin -amoxicillin quadruple therapy and 14-d levofloxacin-amoxicillin triple therapy (87% vs 83%, respectively)[[33]].
ofloxacin 10369 between the eradication rates of second-line 14-d levofloxacin-amoxicillin quadruple therapy and 14-d lev ofloxacin -amoxicillin triple therapy (87% vs 83%, respectively)[[33]]. However, the former had a higher eradication
ofloxacin 10497 therapy (87% vs 83%, respectively)[[33]]. However, the former had a higher eradication rate for lev ofloxacin -resistant strains than the latter (71% vs 37%)[[33]].TL quadruple therapyRecently, Hsu et al[[17]] developed
ofloxacin 10843 tripotassium dicitrato bismuthate 120 mg four times daily, tetracycline 500 mg four times daily, and lev ofloxacin 500 mg once daily for 10 d (Table 1). The simple regimen maintains a high eradication rate for H. pylori
ofloxacin 10974 10 d (Table 1). The simple regimen maintains a high eradication rate for H. pylori strains with lev ofloxacin resistance[[17]]. A randomized control study showed that as a second-line anti-H. pylori treatment,
ofloxacin 11175 treatment, 10-d of TL quadruple therapy achieved a much higher eradication rate compared with 10-d lev ofloxacin triple therapy containing esomeprazole, amoxicillin and levofloxacin (98% vs 68%, respectively)[[34]].
ofloxacin 11244 eradication rate compared with 10-d levofloxacin triple therapy containing esomeprazole, amoxicillin and lev ofloxacin (98% vs 68%, respectively)[[34]]. Subgroup analysis revealed that the former was superior to the latter
ofloxacin 11640 eradication failure by bismuth quadruple therapy as a first-line treatment, and both TL quadruple and lev ofloxacin -amoxicillin triple therapies had a 100% eradication rate in this subgroup of patients. The data suggests
ofloxacin 12562 treatment for H. pylori infection (89% vs 52%), and had an eradication rate comparable with 7-d lev ofloxacin -amoxicillin triple therapy (79%)[[35]]. Another randomized controlled trial from Germany demonstrated
ofloxacin 13630 10-d TL quadruple regimen can maintain a high eradication rate (> 90%) for H. pylori strains with lev ofloxacin resistance[[34]]. However, the choice of second line rescue regimen also depends on regional factors.
ofloxacin 14415 failure of standard triple therapy. As TL quadruple therapy achieves a higher eradication rate than lev ofloxacin triple therapy, and high-dose dual therapy has a comparable eradication rate with levofloxacin-amoxicillin
ofloxacin 14510 than levofloxacin triple therapy, and high-dose dual therapy has a comparable eradication rate with lev ofloxacin -amoxicillin triple therapy in patients with failure of standard triple therapy[[34],[35]], both TL quadruple
ofloxacin 14836 therapy (Figure 1).Figure 1Algorism for second-line therapy of Helicobacter pylori infection. Lev: Lev ofloxacin ; Amo: Amoxicillin; Tet: Tetracycline.After failure of a non-bismuth quadruple therapyThe Maastricht
ofloxacin 15015 quadruple therapyThe Maastricht V/Florence Consensus Report recommends bismuth quadruple therapy, lev ofloxacin -amoxicillin triple therapy and levofloxacin-amoxicillin quadruple therapy as rescue treatments after
ofloxacin 15059 Consensus Report recommends bismuth quadruple therapy, levofloxacin-amoxicillin triple therapy and lev ofloxacin -amoxicillin quadruple therapy as rescue treatments after failure of a non-bismuth quadruple therapy[[31]].
ofloxacin 15228 failure of a non-bismuth quadruple therapy[[31]]. As 10-d TL quadruple therapy is superior to 10-d lev ofloxacin -amoxicillin triple therapy, it is reasonable to recommend TL-quadruple therapy as the rescue treatment
ofloxacin 15752 eradication failure by bismuth quadruple therapy for H. pylori infection. As both TL quadruple and lev ofloxacin -amoxicillin triple therapies achieved a 100% cure rate in this setting. TL quadruple therapy may also
tetracycline 1568 has an eradication efficacy comparable with levofloxacin-amoxicillin triple therapy. Recently, a 10-d tetracycline -levofloxacin (TL) quadruple therapy comprised of a proton pump inhibitor, bismuth, tetracycline and
tetracycline 1664 10-d tetracycline-levofloxacin (TL) quadruple therapy comprised of a proton pump inhibitor, bismuth, tetracycline and levofloxacin has been developed, which achieves a markedly higher eradication rate compared with
tetracycline 2902 dual therapy has an eradication rate comparable with levofloxacin-amoxicillin triple therapy. Ten-day tetracycline -levofloxacin quadruple therapy achieves a markedly higher eradication rate compared with levofloxacin-amoxicillin
tetracycline 3169 with failure of standard triple, bismuth quadruple or non-bismuth quadruple therapy. In conclusion, tetracycline -levofloxacin quadruple therapy has the potential to become a universal second-line treatment for H.
tetracycline 5495 therapy, the rates of drug resistance to clarithromycin, metronidazole, levofloxacin, amoxicillin and tetracycline are 65%-75%, 30%-56%, 26%-37%, 0%-6.1% and 0%-10%, respectively[[12]-[16]]. Whereas for patients who
tetracycline 5755 therapy, the rates of drug resistance to clarithromycin, metronidazole, levofloxacin, amoxicillin and tetracycline are 75%, 75%, 25%, 0%, and 0%, respectively[[17],[18]]. This data implies that amoxicillin, tetracycline
tetracycline 5860 tetracycline are 75%, 75%, 25%, 0%, and 0%, respectively[[17],[18]]. This data implies that amoxicillin, tetracycline and levofloxacin are good choices of antibiotics for rescue treatment of H. pylori infection.Point mutations
tetracycline 6968 therapy, fluoroquinolone-amoxicillin triple therapy, fluoroquinolone-amoxicillin quadruple therapy, tetracycline -levofloxacin (TL) quadruple therapy and high-dose dual therapy.Bismuth quadruple therapyBismuth quadruple
tetracycline 7165 therapyBismuth quadruple therapy consists of a proton pump inhibitor (PPI), bismuth, metronidazole and tetracycline (Table 1). The standard regimen comprises PPI twice daily, colloidal bismuth subcitrate 120 mg four
tetracycline 7291 The standard regimen comprises PPI twice daily, colloidal bismuth subcitrate 120 mg four times daily, tetracycline 500 mg four times daily and metronidazole 500 mg three times daily for 10 to 14 d. A pool analysis demonstrated
tetracycline 10798 consists of esomeprazole 40 mg twice daily, tripotassium dicitrato bismuthate 120 mg four times daily, tetracycline 500 mg four times daily, and levofloxacin 500 mg once daily for 10 d (Table 1). The simple regimen maintains
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