Levofloxacin and proton pump inhibitor-based triple therapy versus standard triple first-line therapy for Helicobacter pylori eradication.

BACKGROUND: Standard triple therapy for Helicobacter pylori infection fails in up to one quarter of patients. Levofloxacin-based triple therapy may be more efficacious. OBJECTIVE: The aim of this paper was to compare levofloxacin and proton pump inhibitor-based triple therapy with standard triple therapy for H. pylori infection. METHODS: PubMed, Embase, Cochrane Central Register of Controlled Trials, ClinicalTrials.gov, Google Scholar, and Ovid were systematically searched to identify randomized controlled trials comparing levofloxacin and proton pump inhibitor-based therapy with standard triple therapy in treatment-naive patients with H. pylori infection until August 2013. RESULTS: Ten randomized controlled trials involving 2676 patients (1357 in the levofloxacin group and 1319 in the control group) met the inclusion criteria. The pooled odds ratio by intention-to-treat analysis and by per protocol analysis in the levofloxacin regimen versus standard regimen was 1.28 [95% confidence interval (CI): 0.88-1.85] and 1.23 (95% CI: 0.82-1.84) by the random effects model, respectively. There was no statistical significance of the incidence of total side effects between the groups, but levofloxacin-based therapy was associated with a significant reduction in the incidence of taste disturbance compared with standard third therapy. CONCLUSION: Levofloxacin-based therapy was as safe and effective as triple therapy for H. pylori infection and could be considered as an additional treatment option. However, more rigorous research is required to accurately assess the role of levofloxacin in eradicating H. pylori infection.

[Study on the toxic reaction induced by single dose of qingkailing injection].

OBJECTIVE: To study the toxic reaction induced by Qingkailing Injection. METHODS: Kunming mice were injected single dose of Qingkailing Injection via tail vein and observed for 14 days to test the toxic reaction of the drug. According to Chinese Pharmacopoeia, hemolysis tests were conducted on the injections of different lots and each ingredient of the injection. RESULTS: Toxic reaction induced by single dose of injection--with dose increasing,mice quickly showed different responses such as hypodynamia, convulsion, syncope and even death after injection. In the high dose group, blood routine detection showed that mice have lower counts of RBC, WBC and lower content of hemoglobin; The pulmonary pathological sections of dead mice showed significant hyperemia. And there were no significant difference in the contents of serum electrolyte (K+, Na+, Ca2+) between normal saline control group and Qingkailing injection group. Hemolysis test in vitro--Honeysuckle extraction (significantly) and gardenia extraction which were components of Qing-kailing injection caused hemolysis in certain dose; While gardenia, pearl shell and isatis root extraction caused RBC agglutination. With higher concentration, the Qingkailing injections of different lot caused different degree of hemolysis. There was no significant difference in the hemolysis test in vitro between the group of Balb/C mice which were sensitized by Qingkailing injection or not. CONCLUSION: In clinical practice some adverse reactions induced by Qingkailing injection occurred concomitantly with acute hemolysis within vessels, which might be caused by honeysuckle and gardenia. And the hemolysis was independent of allergy.