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Comparison of 10-day levofloxacin bismuth-based quadruple therapy and levofloxacin-based triple therapy for Helicobacter pylori.
- Source :
-
Journal of digestive diseases [J Dig Dis] 2017 Sep; Vol. 18 (9), pp. 537-542. - Publication Year :
- 2017
-
Abstract
- Objective: This was a prospective study aiming to investigate whether levofloxacin plus bismuth-based quadruple therapy was more effective than levofloxacin-based triple therapy after failed first-line eradication therapies for Helicobacter pylori (H. pylori) infection.<br />Methods: Sixty-seven patients infected with H. pylori were randomly assigned to two groups; the levofloxacin plus bismuth-based quadruple therapy group (RBAL [n = 33]; rabeprazole 20 mg twice daily, bismuth subcitrate 120 mg four times daily, amoxicillin 1 g twice daily and levofloxacin 500 mg once daily, for 10 days) and the levofloxacin-based triple therapy group (RAL [n = 34]; rabeprazole 20 mg twice daily, amoxicillin 1 g twice daily and levofloxacin 500 mg once daily, for 10 days). Endoscopy was performed 4-8 weeks after H. pylori eradication to assess treatment response. We followed up patient response and compliance and checked their resistance to antibiotics.<br />Results: Intention-to-treat analysis revealed that both groups had similar eradication rates (RBAL vs RAL: 84.8% [95% confidence interval {CI} 72.6-97.1%] vs 67.6% [95% CI 51.9-83.4%], P = 0.0987). No significant differences in compliance or adverse events were found (P = 0.9829 and 0.0720). Epsilometer test showed that most eradication failure cases were levofloxacin-resistant.<br />Conclusions: Adding bismuth subcitrate to levofloxacin-based triple therapy was not more effective than not doing so, but no further side effects were noted. Both eradication therapies were equally safe and patients had the same tolerance to both regimens. Resistance rate to levofloxacin may be important when choosing second-line therapy.<br /> (© 2017 Chinese Medical Association Shanghai Branch, Chinese Society of Gastroenterology, Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine and John Wiley & Sons Australia, Ltd.)
- Subjects :
- Adult
Aged
Amoxicillin therapeutic use
Antacids adverse effects
Anti-Bacterial Agents adverse effects
Disk Diffusion Antimicrobial Tests
Drug Resistance, Bacterial
Drug Therapy, Combination adverse effects
Female
Gastroscopy
Helicobacter Infections diagnostic imaging
Humans
Levofloxacin adverse effects
Male
Medication Adherence
Middle Aged
Organometallic Compounds adverse effects
Prospective Studies
Proton Pump Inhibitors therapeutic use
Rabeprazole therapeutic use
Retreatment
Antacids therapeutic use
Anti-Bacterial Agents therapeutic use
Helicobacter Infections drug therapy
Helicobacter pylori drug effects
Levofloxacin therapeutic use
Organometallic Compounds therapeutic use
Subjects
Details
- Language :
- English
- ISSN :
- 1751-2980
- Volume :
- 18
- Issue :
- 9
- Database :
- MEDLINE
- Journal :
- Journal of digestive diseases
- Publication Type :
- Academic Journal
- Accession number :
- 28644575
- Full Text :
- https://doi.org/10.1111/1751-2980.12498