PMID- 28361211
OWN - NLM
STAT- MEDLINE
DCOM- 20170515
LR  - 20181202
IS  - 1179-1950 (Electronic)
IS  - 0012-6667 (Linking)
VI  - 77
IP  - 7
DP  - 2017 May
TI  - Efficacy and Safety of Quinolone-Containing Rescue Therapies After the Failure of 
      Non-Bismuth Quadruple Treatments for Helicobacter pylori Eradication: Systematic 
      Review and Meta-Analysis.
PG  - 765-776
LID - 10.1007/s40265-017-0730-4 [doi]
AB  - BACKGROUND: Anti-Helicobacter pylori eradication treatment fails in a significant 
      percentage of cases. Although this percentage has been reduced to 5-15% with the 
      use of non-bismuth quadruple therapies, limited data exist regarding rescue after 
      failure of these treatments. AIM: The aim of this study was to systematically 
      review the efficacy and safety of quinolone-containing therapies after the 
      failure of non-bismuth quadruple regimens. METHODS: Studies evaluating the 
      efficacy of second-line quinolone-containing therapies after the failure of 
      non-bismuth sequential or concomitant regimens were selected. Efficacy (by 
      intention to treat) was analyzed using the inverse variance method; safety data 
      were recorded as the occurrence of any adverse event. The risk of bias of each 
      primary study was evaluated using the Risk of Bias in Non-randomized Studies-of 
      Interventions (ROBINS-I) tool. The quality of the evidence was summarized using 
      the Grades of Recommendation, Assessment, Development and Evaluation (GRADE) 
      approach. RESULTS: Sixteen studies were included. The 10-day 
      levofloxacin/amoxicillin/proton pump inhibitor (PPI) triple therapy (LT) achieved 
      eradication rates of 80% (95% CI 71-88). Regarding the 
      moxifloxacin/amoxicillin/PPI triple therapy (MT), its efficacy was higher when 
      administered for 14 days instead of 7 days (80 vs 63%). Two studies investigated 
      the levofloxacin/bismuth-containing quadruple therapies (LBQ) obtaining 
      eradication rates over 90%. Safety was similar in all treatments. The sensitivity 
      analyses showed that results for LT were robust, but MT had weak evidence. 
      CONCLUSIONS: Quinolone-containing triple therapies reported eradication rates 
      </=80%, but LBQ therapies showed encouraging rates. However, the strength of the 
      evidence was very low. The efficacy of LBQ should be corroborated in more 
      studies, and the usefulness of quinolones needs to be evaluated in areas with 
      moderate to high bacterial resistances.
FAU - Marin, Alicia C
AU  - Marin AC
AD  - Gastroenterology Unit, Hospital Universitario de La Princesa, Instituto de 
      Investigacion Sanitaria Princesa (IIS-IP), Madrid, Spain.
AD  - Centro de Investigacion Biomedica en Red de Enfermedades Hepaticas y Digestivas 
      (CIBERehd), Madrid, Spain.
FAU - Nyssen, Olga P
AU  - Nyssen OP
AD  - Gastroenterology Unit, Hospital Universitario de La Princesa, Instituto de 
      Investigacion Sanitaria Princesa (IIS-IP), Madrid, Spain.
AD  - Centro de Investigacion Biomedica en Red de Enfermedades Hepaticas y Digestivas 
      (CIBERehd), Madrid, Spain.
FAU - McNicholl, Adrian G
AU  - McNicholl AG
AD  - Gastroenterology Unit, Hospital Universitario de La Princesa, Instituto de 
      Investigacion Sanitaria Princesa (IIS-IP), Madrid, Spain. adrian.mcn@gmail.com.
AD  - Centro de Investigacion Biomedica en Red de Enfermedades Hepaticas y Digestivas 
      (CIBERehd), Madrid, Spain. adrian.mcn@gmail.com.
FAU - Gisbert, Javier P
AU  - Gisbert JP
AD  - Gastroenterology Unit, Hospital Universitario de La Princesa, Instituto de 
      Investigacion Sanitaria Princesa (IIS-IP), Madrid, Spain.
AD  - Centro de Investigacion Biomedica en Red de Enfermedades Hepaticas y Digestivas 
      (CIBERehd), Madrid, Spain.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Review
PT  - Systematic Review
PL  - New Zealand
TA  - Drugs
JT  - Drugs
JID - 7600076
RN  - 0 (Antacids)
RN  - 0 (Fluoroquinolones)
RN  - 0 (Proton Pump Inhibitors)
RN  - 0 (Quinolones)
RN  - 6GNT3Y5LMF (Levofloxacin)
RN  - 804826J2HU (Amoxicillin)
RN  - H1250JIK0A (Clarithromycin)
RN  - U015TT5I8H (Bismuth)
RN  - U188XYD42P (Moxifloxacin)
SB  - IM
MH  - Amoxicillin/administration & dosage/adverse effects
MH  - Antacids/administration & dosage/adverse effects
MH  - Bismuth/administration & dosage
MH  - Clarithromycin/administration & dosage/adverse effects
MH  - Drug Therapy, Combination
MH  - Fluoroquinolones/administration & dosage/adverse effects
MH  - Helicobacter Infections/*drug therapy/microbiology
MH  - Helicobacter pylori/*drug effects
MH  - Humans
MH  - Levofloxacin/administration & dosage/adverse effects/therapeutic use
MH  - Moxifloxacin
MH  - Proton Pump Inhibitors/*administration & dosage/adverse effects
MH  - Quinolones/*administration & dosage/adverse effects
EDAT- 2017/04/01 06:00
MHDA- 2017/05/16 06:00
CRDT- 2017/04/01 06:00
PHST- 2017/04/01 06:00 [pubmed]
PHST- 2017/05/16 06:00 [medline]
PHST- 2017/04/01 06:00 [entrez]
AID - 10.1007/s40265-017-0730-4 [pii]
AID - 10.1007/s40265-017-0730-4 [doi]
PST - ppublish
SO  - Drugs. 2017 May;77(7):765-776. doi: 10.1007/s40265-017-0730-4.