The latest guidelines for the management of H. pylori infection in Italy recommend 10-day levofloxacin-amoxicillin after the failure of first-line therapy
Because of the emergence of antibiotic resistance, reviews of the most effective antibiotics for the treatment of specific conditions are now routinely carried out. Helicobacter pylori (HP) is a very widespread condition that requires a combination of antibiotics for its successful eradication. Efforts to standardize HP treatment have been made in many countries and this paper describes the III Working Group Consensus Report 2015 produced as guidelines for the management of H. pylori in Italy.
The report was produced by experts from different regions of Italy chosen because of their experience in the treatment of HP and their contributions to HP research. These guidelines are endorsed by the Italian Society of Gastroenterology and the Italian Society of Digestive Endoscopy. The panel of experts carried out a systematic review of the literature on HP including its diagnosis using non-invasive and invasive tests, its treatment and the role of HP treatment for the prevention of gastric cancer.
A series of statements were produced and one of these involved what to do after the failure of first-line therapy. In this case a 10-day triple therapy with levofloxacin-amoxicillin is proposed as second-line treatment with bismuth-containing quadruple therapy as an alternative. The statement cites evidence emerging from clinical practice of a cumulative 90-95% HP eradication rate using 10-day levofloxacin-amoxicillin triple therapy. This statement had a recommendation grade of A which was the highest possible and an evidence level of 1, again the highest possible.
Dig Liver Dis. 2015 Nov;47(11):903-12. doi: 10.1016/j.dld.2015.06.010. Epub 2015 Jul 6.
Source : http://www.ncbi.nlm.nih.gov/pubmed/26253555?dopt=Abstract