Tu1350 Helicobacter pylori Eradication Rates and Related Factors by Second-Line Bismuth-Based Quadruple Therapy

Efficacy and safety of high‐dose dual therapy for Helicobacter pylori rescue therapy: A systematic review and meta‐analysis

“…The variability of treatment success with current versions makes it hard to recommend it as a routine first‐line therapy. However, there may be a role for it as a second‐line therapy as bismuth salts are not available worldwide and even where they are available, the efficacy of second‐line bismuth‐based quadruple therapy for H. pylori infection may be compromised by its side effects . In addition, the efficacy of levofloxacin‐containing triple therapy may continue to drop due to the increasing prevalence of levofloxacin‐resistant H. pylori strains in many countries, with rates as high as 34.5% in China, 31.3% in the USA and 22.1% in Italy.…”

“…However, there may be a role for it as a second-line therapy as bismuth salts are not available worldwide and even where they are available, the efficacy of second-line bismuth-based quadruple therapy for H. pylori infection may be compromised by its side effects. 50 In addition, the efficacy of levofloxacin-containing triple therapy may continue to drop due to the increasing prevalence of levofloxacin-resistant H. pylori strains in many countries, with rates as high as 34.5% in China, 4 31.3% in the USA 11 and 22.1% in Italy 51 . H. pylori resistance to amoxicillin, both primary and acquired, remains rare 1,[8][9][10][11] and, based on our findings, there may be a role for high-dose dual therapy after the failure of clarithromycin-containing standard triple therapy or in those infected with clarithromycinresistant H. pylori strains.…”