PMID- 21989146
OWN - NLM
STAT- MEDLINE
DCOM- 20120103
LR  - 20220410
IS  - 1572-0241 (Electronic)
IS  - 0002-9270 (Print)
IS  - 0002-9270 (Linking)
VI  - 106
IP  - 11
DP  - 2011 Nov
TI  - A randomized study comparing levofloxacin, omeprazole, nitazoxanide, and 
      doxycycline versus triple therapy for the eradication of Helicobacter pylori.
PG  - 1970-5
LID - 10.1038/ajg.2011.306 [doi]
AB  - OBJECTIVES: Resistance to standard Helicobacter pylori (HP) treatment regimens 
      has led to unsatisfactory cure rates in HP-infected patients. This study was 
      designed to evaluate a novel four-drug regimen (three antibiotics and a proton 
      pump inhibitor (PPI)) for eradication of HP infection in treatment-naive 
      patients. METHODS: Patients with a diagnosis of HP gastritis or peptic ulcer 
      disease confirmed using endoscopy and stool antigen testing were eligible for 
      inclusion in this study. All patients underwent a washout period of 6 weeks from 
      any prior antibiotic or PPI usage. Patients were then randomized to either 
      levofloxacin, omeprazole, nitazoxanide, and doxycycline (LOAD) therapy for 7 days 
      (LOAD-7) or 10 days (LOAD-10), including levofloxacin 250 mg with breakfast, 
      omeprazole 40 mg before breakfast, nitazoxanide (Alina) 500 mg twice daily with 
      meals and doxycycline 100 mg at dinner, or lansoprozole, amoxicillin, and 
      clarithromycin (LAC) therapy for 10 days, which included lansoprozole 30 mg, 
      amoxicillin 1 g with breakfast and dinner, and clarithromycin 500 mg with 
      breakfast and dinner. HP eradication was confirmed by stool antigen testing at 
      least 4 weeks after cessation of therapy. RESULTS: Intention-to-treat analysis 
      revealed significant differences (P<0.05) in the respective eradication rates of 
      the LOAD therapies (88.9% (80/90) LOAD-10, 90% (81/90) LOAD-7, 89.4% (161/180) 
      for combined LOAD) compared with those receiving LAC, 73.3% (66/90). There were 
      no differences in adverse effects between the groups. CONCLUSIONS: This 
      open-label, prospective trial demonstrates that LOAD is a highly active regimen 
      for the treatment of HP in treatment-naive patients. A large randomized 
      controlled trial is warranted to further evaluate the efficacy of this regimen.
FAU - Basu, P Patrick
AU  - Basu PP
AD  - Department of Gastroenterology, Hepatology and Liver Transplant, Columbia 
      University, College of Physicians and Surgeons, New York, New York, USA. 
      basu.patrick@gmail.com
FAU - Rayapudi, Krishna
AU  - Rayapudi K
FAU - Pacana, Tommy
AU  - Pacana T
FAU - Shah, Niraj James
AU  - Shah NJ
FAU - Krishnaswamy, Nithya
AU  - Krishnaswamy N
FAU - Flynn, Molly
AU  - Flynn M
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Randomized Controlled Trial
DEP - 20111011
PL  - United States
TA  - Am J Gastroenterol
JT  - The American journal of gastroenterology
JID - 0421030
RN  - 0 (2-Pyridinylmethylsulfinylbenzimidazoles)
RN  - 0 (Anti-Bacterial Agents)
RN  - 0 (Anti-Ulcer Agents)
RN  - 0 (Nitro Compounds)
RN  - 0 (Proton Pump Inhibitors)
RN  - 0 (Thiazoles)
RN  - 0K5C5T2QPG (Lansoprazole)
RN  - 6GNT3Y5LMF (Levofloxacin)
RN  - 804826J2HU (Amoxicillin)
RN  - A4P49JAZ9H (Ofloxacin)
RN  - H1250JIK0A (Clarithromycin)
RN  - KG60484QX9 (Omeprazole)
RN  - N12000U13O (Doxycycline)
RN  - SOA12P041N (nitazoxanide)
SB  - IM
CIN - Am J Gastroenterol. 2011 Nov;106(11):1976-7. PMID: 22056576
CIN - Am J Gastroenterol. 2012 Jul;107(7):1106-7; author reply 1107. PMID: 22764031
MH  - 2-Pyridinylmethylsulfinylbenzimidazoles/therapeutic use
MH  - Adult
MH  - Amoxicillin/therapeutic use
MH  - Anti-Bacterial Agents/administration & dosage/*therapeutic use
MH  - Anti-Ulcer Agents/administration & dosage/*therapeutic use
MH  - Clarithromycin/therapeutic use
MH  - Doxycycline/administration & dosage/therapeutic use
MH  - Drug Therapy, Combination
MH  - Female
MH  - Helicobacter Infections/complications/*drug therapy
MH  - *Helicobacter pylori
MH  - Humans
MH  - Intention to Treat Analysis
MH  - Lansoprazole
MH  - Levofloxacin
MH  - Male
MH  - Middle Aged
MH  - Nitro Compounds
MH  - Ofloxacin/administration & dosage/therapeutic use
MH  - Omeprazole/administration & dosage/therapeutic use
MH  - Prospective Studies
MH  - Proton Pump Inhibitors/administration & dosage/*therapeutic use
MH  - Recurrence
MH  - Thiazoles/administration & dosage/therapeutic use
MH  - Young Adult
PMC - PMC3209586
EDAT- 2011/10/13 06:00
MHDA- 2012/01/04 06:00
CRDT- 2011/10/13 06:00
PHST- 2011/10/13 06:00 [entrez]
PHST- 2011/10/13 06:00 [pubmed]
PHST- 2012/01/04 06:00 [medline]
AID - ajg2011306 [pii]
AID - 10.1038/ajg.2011.306 [doi]
PST - ppublish
SO  - Am J Gastroenterol. 2011 Nov;106(11):1970-5. doi: 10.1038/ajg.2011.306. Epub 2011 
      Oct 11.