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Clinical trial: levofloxacin‐based quadruple therapy was inferior to traditional quadruple therapy in the treatment of resistant Helicobacter pylori infection
Author(s) -
YEE Y. K.,
CHEUNG T. K.,
CHU K.M.,
CHAN C. K.,
FUNG J.,
CHAN P.,
BUT D.,
HUNG I.,
CHAN A. O. O.,
YUEN M. F.,
HSU A.,
WONG B. C. Y.
Publication year - 2007
Publication title -
alimentary pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.308
H-Index - 177
eISSN - 1365-2036
pISSN - 0269-2813
DOI - 10.1111/j.1365-2036.2007.03452.x
Subject(s) - levofloxacin , medicine , esomeprazole , amoxicillin , helicobacter pylori , metronidazole , gastroenterology , breath test , urea breath test , pharmacotherapy , intention to treat analysis , combination therapy , randomized controlled trial , antibiotics , helicobacter pylori infection , microbiology and biotechnology , biology
Summary Background The efficacy of levofloxacin‐based quadruple therapy in resistant Helicobacter pylori infection is not known. Aim To test the efficacy of levofloxacin‐based quadruple therapy and traditional quadruple therapy in resistant H. pylori infection. Methods One hundred and two patients with resistant H. pylori infection were randomized to 1 week of either EBAL (esomeprazole 40 mg b.d., bismuth subcitrate 240 mg b.d., amoxicillin 1 g b.d. and levofloxacin 500 mg b.d.) or EBMT (esomeprazole 40 mg b.d., bismuth subcitrate 240 mg b.d., metronidazole 400 mg t.d.s. and tetracycline 500 mg q.d.s.). 13 C‐urea breath test was performed at week 12 to assess post‐treatment H. pylori status. Results In intention‐to‐treat analysis H. pylori eradication was achieved in 37 of 51 (73%) subjects in EBAL and 45 of 51 (88%) subjects in EBMT groups, respectively ( P = 0.046). Per‐protocol eradication rates of EBAL and EMBT groups were 78% and 94%, respectively ( P = 0.030). The intention‐to‐treat eradication rate was statistically lower for EBAL than EMBT (56% vs. 90%, P = 0.013) among those who had failed more than one course of eradication therapy. Previous levofloxacin triple therapy did not affect the efficacy of either protocol significantly. Conclusions Levofloxacin‐based quadruple therapy was inferior to traditional quadruple therapy for resistant H. pylori infection.