Premium
Ten‐Day Quadruple Therapy Comprising Proton‐Pump Inhibitor, Bismuth, Tetracycline, and Levofloxacin Achieves a High Eradication Rate for H elicobacter pylori Infection after Failure of Sequential Therapy
Author(s) -
Hsu PingI,
Chen WenChi,
Tsay FengWoei,
Shih ChihAn,
Kao SungShuo,
Wang HuayMin,
Yu HsienChung,
Lai KwokHung,
Tseng HuiHwa,
Peng NanJing,
Chen Angela,
Kuo ChaoHung,
Wu DengChyang
Publication year - 2014
Publication title -
helicobacter
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.206
H-Index - 79
eISSN - 1523-5378
pISSN - 1083-4389
DOI - 10.1111/hel.12085
Subject(s) - levofloxacin , esomeprazole , helicobacter pylori , medicine , clarithromycin , proton pump inhibitor , gastroenterology , tetracycline , combination therapy , pharmacotherapy , antibiotics , microbiology and biotechnology , biology
Background Sequential therapy has been recommended in the M aastricht IV / F lorence C onsensus R eport as the first‐line treatment for H elicobacter pylori eradication in regions with high clarithromycin resistance. However, it fails in 5–24% of infected subjects, and the recommended levofloxacin‐containing triple rescue therapy only achieves a 77% eradication rate after failure of sequential therapy. Aim To investigate the efficacy of a novel quadruple therapy comprising proton‐pump inhibitor, bismuth, tetracycline, and levofloxacin for rescue treatment of sequential therapy. Methods This was a multicenter study in which H . pylori ‐infected patients who had failed sequential therapy received a 10‐day quadruple therapy (esomeprazole (40 mg b.d), tripotassium dicitrato bismuthate (120 mg q.d.s.), tetracycline (500 mg q.d.s.), and levofloxacin (500 mg o.d.) for 10 days). H . pylori status was examined 6 weeks after the end of treatment. Results From J uly 2007 to J une 2012, twenty‐four subjects received 10‐day quadruple therapy. The eradication rates according to intention‐to‐treat and per‐protocol analyses were both 95.8% (23 of 24; 95% confidence interval, 87.8–103.8%). Adverse events were seen in 25.0% (6 of 24) of the patients. Drug compliance was 100.0% (24/24). Conclusions The 10‐day quadruple therapy comprising proton‐pump inhibitor, bismuth, tetracycline, and levofloxacin achieves a very high eradication rate for H . pylori infection after failure of sequential therapy. It is well tolerated and has great potential to become a good choice of rescue treatment following non‐bismuth‐containing quadruple therapy in regions with high clarithromycin resistance.