ArticleBMC gastroenterology2019
Cefuroxime, levofloxacin, esomeprazole, and bismuth as first-line therapy for eradicating Helicobacter pylori in patients allergic to penicillin.
Article in BMC gastroenterology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
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Who cites it
16 citing papers in PubMed, 27 citations in OpenAlex.
- A Review on the Progress and Strategies ofGastroenterology research and practice · 2026Review
- Efficacy of a reduced-drug burden quadruple therapy with vonoprazan, cefuroxime, minocycline, and bismuth forFrontiers in medicine · 2026Article
- Clinical Effectiveness of Penicillin-Free Therapies in First-Line and Rescue Treatments forAntibiotics (Basel, Switzerland) · 2025Review
- A retrospective pharmacovigilance study of post-marketing safety concerns with cefuroxime.Therapeutic advances in drug safety · 2024Article
- Newer, Older, and Alternative Agents for the Eradication ofAntibiotics (Basel, Switzerland) · 2023Review
- Treatment ofAntibiotics (Basel, Switzerland) · 2023Review
- Primary Antibiotic Resistance ofPathogens (Basel, Switzerland) · 2022Review
- The Efficacy, Safety, and Tolerability of Levofloxacin Quadruple Therapy forEvidence-based complementary and alternative medicine : eCAM · 2022Article
- Antibiotics Resistance Prevalence ofInfection and drug resistance · 2022Article
- Treatment ofWorld journal of gastroenterology · 2021Review
- Metal homeostasis in pathogenic Epsilonproteobacteria: mechanisms of acquisition, efflux, and regulation.Metallomics : integrated biometal science · 2021Review
- The status and progress of first-line treatment againstTherapeutic advances in gastroenterology · 2021Review
- Identification of Potential Drug Targets inPathogens (Basel, Switzerland) · 2020Article
- BestAntibiotics (Basel, Switzerland) · 2020Review
- Recent progress in Helicobacter pylori treatment.Chinese medical journal · 2020Review
- Article
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Authors and funding
3 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundEradicating Helicobacter pylori infection is clinically challenging, notably in cases with penicillin allergy. Cephalosporin could be used in lieu of amoxicillin to eradicate Helicobacter pylori. The current work aimed to assess therapeutic efficacy and safety of a cefuroxime-based quadruple regimen in treatment-naïve individuals with penicillin allergy, as well as patient compliance.
methodsIn the present prospective single-center cohort study, 152 Helicobacter pylori infected individuals with penicillin allergy received eradication therapy with cefuroxime (500 mg twice/day), levofloxacin (500 mg once/day), esomeprazole (20 mg twice/day) and bismuth potassium citrate (220 mg twice/day; 14 days). Safety and compliance were evaluated 1 to 3 days upon eradication. The urea breath test was carried out 8 to 12 weeks upon eradication for efficacy assessment.
resultsThis quadruple antimicrobial regimen eradicated the pathogen at 85.5% (95% confidence interval (CI) 79.6-90.8%), 88.4% (95% CI 83.0-93.2%) and 90.1% (95% CI 85.2-94.4%) in intention-to-treat, modified intention-to-treat and per-protocol analyses, respectively, with resistance rates of 4.6 and 40.0% in the background of cefuroxime and levofloxacin, respectively. Meanwhile, 21.3% of patients had adverse reactions, but none was serious. A total of 95.3% of patients showed good compliance. Poor compliance and cefuroxime resistance were detected by uni- or multivariate analyses as independent factors predicting therapeutic failure. Eradication rates in patients with dual levofloxacin and cefuroxime susceptibility, isolated levofloxacin resistance, isolated cefuroxime resistance and dual resistance were 97.2, 84.0, 50.0, and 0%, respectively (P = 0.002).
conclusionsCefuroxime, levofloxacin, esomeprazole, and bismuth achieved decent efficacy, safety and compliance as first-line antimicrobial regimen in patients with Helicobacter pylori and penicillin allergy.
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