Ten-Day versus 14-Day Levofloxacin-Containing Triple Therapy for Second-Line Anti-Helicobacter pyloriEradication in Taiwan

Abstract

Second-line Helicobacter pylori (H. pylori) eradication with fluoroquinolone-containing triple therapy is one of the recommended treatment options, but neither 7-day nor 10-day regimens provide >90% success rates. The current retrospective study aimed to clarify the effects of 10-day and 14-day levofloxacin-containing triple therapies for second-line H. pylori eradication in a Taiwanese cohort and to evaluate the potential clinical factors influencing eradication. A total of 200 patients who failed H. pylori eradication using the standard triple therapy were prescribed with either a 10-day (EAL-10) or a 14-day (EAL-14) levofloxacin-containing triple therapy group (levofloxacin 500 mg once daily, amoxicillin 1 g twice daily, and esomeprazole 40 mg twice daily). Follow-up studies to assess treatment response were carried out 8 weeks later. Eradication rates attained by EAL-10 and EAL-14 were 75.6%; 95% CI = 63.9–85.3% and 92.5%; 95% CI = 84.5–98.1%, P = 0.002 in the per protocol analysis and 68%; 95% CI = 56.6–78.5% and 86%; 95% CI = 76.8–93.4%, P = 0.002 in the intention-to-treat analysis. The duration of H. pylori therapy is the independent risk factor of H. pylori eradication (P = 0.003). In conclusion, 14-day levofloxacin-containing triple therapy can provide a >90% H. pylori eradication rate, but 10-day treatment duration may be suboptimal. The longer duration of H. pylori therapy (14 days) is the independent risk factor.

Systematic review, meta‐analysis, and meta‐regression: Successful second‐line treatment forHelicobacter pylori

“…Of these, 61 arms (30%) showed PP cure rates >90% . Two studies (two arms) evaluated a dual therapy (rabeprazole and amoxicillin), 34 arms evaluated a triple therapy (Table ), and 25 arms evaluated quadruple therapies (Table ).…”

Systematic review and network meta‐analysis: Comparative effectiveness of therapies for second‐line Helicobacter pylori eradication

“…Bismuth‐containing quadruple therapy for 14 days has been recommended as the second‐line therapy when patients fail to respond to standard triple therapy, and levofloxacin‐containing therapy for 14 days has been recommended as the second‐line therapy when patients fail to respond to clarithromycin‐containing treatment or bismuth quadruple therapy . However, these two therapies, with cure rates of 76% and 78%, respectively, fail to reach the ideal 90% success rate.…”

Medicinal plants in the treatment ofHelicobacter pyloriinfections

“…Clinical practice evidence has revealed that eradication rates are in the range of 80-90%. For example, 14-d quinolone-containing triple therapies as a second-line therapy can provide a 90% H. pylori eradication rate (Tai et al, 2013). A randomized trial of standard triple therapy, 5-d concomitant, and 10-d sequential therapies for H. pylori in seven Latin American sites revealed that the eradication with standard therapy was 82.2% which was higher than the other therapies (Greenberg et al, 2011).…”