Levofloxacin,Metronidazole, and Lansoprazole Triple Therapy Compared to Quadruple Therapy as a Second-Line Treatment of Helicobacter pylori Infection in Korea |
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Authors: | Ji Yoon Moon Gwang Ha Kim Hyun Seok You Bong Eun Lee Dong Yeop Ryu Jae Hoon Cheong Jung Im Jung Jae Hoon Jeong Chul Soo Song Geun Am Song |
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Affiliation: | *Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea.;†Department of Internal Medicine, Busan Medical Center, Busan, Korea.;‡Department of Internal Medicine, Good Samsun Hospital, Busan, Korea. |
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Abstract: | Background/AimsSeveral rescue therapies have been recommended to eradicate Helicobacter pylori infection in patients with a failure of first-line eradication therapy, but they still fail in more than 20% of cases. The aim of this study was to evaluate the efficacy and safety of levofloxacin, metronidazole, and lansoprazole (LML) triple therapy relative to quadruple therapy as a second-line treatment.MethodsIn total, 113 patients who failed first-line triple therapy for H. pylori infection were randomly assigned to two groups: LML for 7 days and tetracycline, bismuth subcitrate, metronidazole and lansoprazole (quadruple) for 7 days.ResultsAccording to intention-to-treat analysis, the infection was eradicated in 38 of 56 patients (67.9%) in the LML group and 48 of 57 (84.2%) in the quadruple group (p=0.042). Per-protocol analysis showed successful eradication in 38 of 52 patients (73.1%) from the LML group and 48 of 52 (92.3%) from the quadruple group (p=0.010). There were no significant differences in the adverse effects in either treatment group.ConclusionsLML therapy is less effective than quadruple therapy as a second-line treatment for H. pylori infection. Therefore, quadruple therapy should be considered as the primary second-line strategy for patients experiencing a failure of first-line H. pylori therapy in Korea. |
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Keywords: | Helicobacter pylori Therapeutics Failure Levofloxacin Metronidazole |
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