Ten‐Day Quadruple Therapy Comprising Proton‐Pump Inhibitor, Bismuth, Tetracycline, and Levofloxacin Achieves a High Eradication Rate for Helicobacter pylori Infection after Failure of Sequential Therapy. Issue 1 (6th September 2013)

• Record Type: Journal Article
• Authors: Hsu, Ping‐I; Chen, Wen‐Chi; Tsay, Feng‐Woei; Shih, Chih‐An; Kao, Sung‐Shuo; Wang, Huay‐Min; Yu, Hsien‐Chung; Lai, Kwok‐Hung; Tseng, Hui‐Hwa; Peng, Nan‐Jing; Chen, Angela; Kuo, Chao‐Hung; Wu, Deng‐Chyang
• Is Part Of: Helicobacter. Volume 19:Issue 1(2014:Feb.)
• Page Start: 74
• Page End: 79
• Publication Date: 2013-09-06
• Subjects: Helicobacter -- Periodicals; Helicobacter infections -- Periodicals; Stomach -- Diseases -- Periodicals; 616.3301405
• DOI: 10.1111/hel.12085
• Languages: English
• ISSNs: 1083-4389

Abstract

<abstract abstract-type="main" id="hel12085-abs-0001"> <title>Abstract</title> <sec id="hel12085-sec-0001" sec-type="section"> <title>Background</title> <p>Sequential therapy has been recommended in the Maastricht IV/Florence Consensus Report as the first‐line treatment for <italic>Helicobacter pylori</italic> 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.</p> </sec> <sec id="hel12085-sec-0002" sec-type="section"> <title>Aim</title> <p>To investigate the efficacy of a novel quadruple therapy comprising proton‐pump inhibitor, bismuth, tetracycline, and levofloxacin for rescue treatment of sequential therapy.</p> </sec> <sec id="hel12085-sec-0003" sec-type="section"> <title>Methods</title> <p>This was a multicenter study in which <italic>H. pylori</italic>‐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). <italic>H. pylori</italic> status was examined 6 weeks after the end of treatment.</p> </sec> <sec id="hel12085-sec-0004" sec-type="section"> <title>Results</title> <p>From July 2007 to June 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).</p> </sec> <sec id="hel12085-sec-0005" sec-type="section"> <title>Conclusions</title> <p>The 10‐day quadruple therapy comprising proton‐pump inhibitor, bismuth, tetracycline, and levofloxacin achieves a very high eradication rate for <italic>H. pylori</italic> 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.</p> </sec> </abstract>