Doxycycline-induced esophagitis: Report of two cases and review of the literature

Although it is not so frequent in medical literature, drug-induced esophageal injury is important, because of its possible complications. Here, we reported two patients with ulcerative esophagitis secondary to doxycycline use. Both patients applied to outpatient clinic with retrosternal pain, odynofagia and dysphagia. Symptoms had been developed after three days of doxicycline treatment in the first patient, and after two days in the second patient. Upper gastrointestinal endoscopy revealed ulcers in patient 1 at the upper 1/3 segment of esophagus and in patient 2 at the middle 1/3 segment of esophagus. Based on the endoscopic findings, the patients were diagnosed as drug-induced esophageal injury resulting from doxycycline treatments. Doxycycline treatments were stopped and lansoprazole and sucralfate was started.

The efficacy of levofloxacin-based triple therapy for first-line Helicobacter pylori eradication

Standard triple therapy composed of a proton pump inhibitor, clarithromycin and amoxicillin has been widely preferred for H. pylori eradication in Turkey and World. Alternative therapies are currently under investigation because of an increase in clarithromycin resistance. The aim of this study was to evaluate the efficacy of a levoflox-acin-containing triple therapy.Materials and methods: The study was carried out in 81 H. pylori-infected patients (52 female, 29 male) with nonul-cer dyspepsia. The mean age was found 46.3 ± 13.9. Treatment was indicated with lansoprazol 30 mg b.d., amoxicil-lin 1 g b.d., and levofloxacin 500 mg daily for 7 days. H. pylori status was rechecked by (14)C urea breath test 6-8 weeks after the end of therapy.Results: Totally 81 patients could complete the treatment and follow-up protocol. Effectiveness was 68%. The distrib-tions of age, gender and smoking were similar between eradicated and non-eradicated groups (p > 0.05).Conclusion: Seven-day levofloxacin based triple therapy is not very effective in the first-line treatment of H. pylori in-fection. The new treatment modalities should be investigated