Details

Autor(en) / Beteiligte

• Hirata, Yoshihiro
• Ohmae, Tomoya
• Yanai, Ayako
• Sakitani, Kosuke
• Hayakawa, Yoku
• Yoshida, Shuntaro
• Sugimoto, Takafumi
• Mitsuno, Yuzo
• Akanuma, Masao
• Yamaji, Yutaka
• Ogura, Keiji
• Maeda, Shin
• Koike, Kazuhiko

Titel

Sitafloxacin resistance in Helicobacter pylori isolates and sitafloxacin-based triple therapy as a third-line regimen in Japan

Ist Teil von

• International journal of antimicrobial agents, 2012-04, Vol.39 (4), p.352-355

Ort / Verlag

Amsterdam: Elsevier B.V

Erscheinungsjahr

2012

Quelle

MEDLINE

Beschreibungen/Notizen

• Abstract The third-line treatment regimen for Helicobacter pylori after failure of clarithromycin- and metronidazole-based therapies is not yet established. Sitafloxacin (STX) is a quinolone that possesses potent in vitro activity against H. pylori. In this study, the susceptibility of H. pylori isolates to STX was examined and the efficacy of STX-based triple therapy as a third-line regimen was evaluated. STX showed minimum inhibitory concentrations (MICs) of ≤1 μg/mL against all 100 H. pylori isolates, and the MIC90 (MIC for 90% of the organisms) of STX was 5 log2 dilutions lower than that of levofloxacin (LVX). The MIC50 (MIC for 50% of the organisms) of STX against gyrA mutants was 0.12 μg/mL and was significantly lower than that of LVX (8 μg/mL). The activity of STX at pH 5.5 was significantly less than that at pH 7.0. In the clinical trial, 28 patients with two eradication failures were treated with STX-based triple therapy [rabeprazole 10 mg twice daily (b.i.d.), amoxicillin 750 mg b.i.d. and STX 100 mg b.i.d. for 7 days]. The eradication rate was 75% using intention-to-treat analysis and 80% using per-protocol analysis. Two gyrA mutant strains were eradicated. Amongst participants, a low pepsinogen I/II ratio was associated with successful eradication. These results suggest that STX could be active against most clinical H. pylori isolates and that STX-based triple therapy is a promising and safe third-line therapy.