RT Journal Article
T1 Helicobacter pylori second-line rescue therapy with levofloxacin- and bismuth-containing quadruple therapy, after failure of standard triple or non-bismuth quadruple treatments
A1 Gisbert, J. P.
A1 Romano, M.
A1 Gravina, A. G.
A1 Solis-Munoz, P.
A1 Bermejo, F.
A1 Molina-Infante, J.
A1 Castro-Fernandez, M.
A1 Ortuno, J.
A1 Lucendo, A. J.
A1 Herranz, M.
A1 Modolell, I.
A1 del Castillo, F.
A1 Gomez, J.
A1 Barrio, J.
A1 Velayos, B.
A1 Gomez, B.
A1 Dominguez, J. L.
A1 Miranda, A.
A1 Martorano, M.
A1 Algaba, A.
A1 Pabon-Carrasco, Manuel
A1 Angueira, T.
A1 Fernandez-Salazar, L.
A1 Federico, A.
A1 Marin, A. C.
A1 McNicholl, A. G.
K1 Concomitant therapy
K1 Sequential therapy
K1 Eradication
K1 Infection
K1 Resistence
K1 Efficacy
AB Background: The most commonly used second-line Helicobacter pylori eradication regimens are bismuth-containing quadruple therapy and levofloxacin-containing triple therapy, both offering suboptimal results. Combining bismuth and levofloxacin may enhance the efficacy of rescue eradication regimens.Aims: To evaluate the efficacy and tolerability of a second-line quadruple regimen containing levofloxacin and bismuth in patients whose previous H. pylori eradication treatment failed.Methods: This was a prospective multicenter study including patients in whom a standard triple therapy (PPI-clarithromycin-amoxicillin) or a non-bismuth quadruple therapy (PPI-clarithromycin-amoxicillin-metronidazole, either sequential or concomitant) had failed. Esomeprazole (40mg b.d.), amoxicillin (1g b.d.), levofloxacin (500mg o.d.) and bismuth (240mg b.d.) was prescribed for 14days. Eradication was confirmed by C-13-urea breath test. Compliance was determined through questioning and recovery of empty medication envelopes. Incidence of adverse effects was evaluated by questionnaires.Results: 200 patients were included consecutively (mean age 47years, 67% women, 13% ulcer). Previous failed therapy included: standard clarithromycin triple therapy (131 patients), sequential (32) and concomitant (37). A total of 96% took all medications correctly. Per-protocol and intention-to-treat eradication rates were 91.1% (95%CI=87-95%) and 90% (95%CI=86-94%). Cure rates were similar regardless of previous (failed) treatment or country of origin. Adverse effects were reported in 46% of patients, most commonly nausea (17%) and diarrhoea (16%); 3% were intense but none was serious.Conclusions: Fourteen-day bismuth- and levofloxacin-containing quadruple therapy is an effective (90% cure rate), simple and safe second-line strategy in patients whose previous standard triple or non-bismuth quadruple (sequential or concomitant) therapies have failed.
PB Wiley
SN 0269-2813
YR 2015
FD 2015-02-23
LK https://hdl.handle.net/10668/28461
UL https://hdl.handle.net/10668/28461
LA en
NO Gisbert JP, Romano M, Gravina AG, Solís-Muñoz P, Bermejo F, Molina-Infante J, et al. Helicobacter pylori second-line rescue therapy with levofloxacin- and bismuth-containing quadruple therapy, after failure of standard triple or non-bismuth quadruple treatments. Aliment Pharmacol Ther. 2015 Apr;41(8):768-75.
DS RISalud
RD Apr 11, 2025