Gut Liver.  2013 Jul;7(4):406-410.

Levofloxacin, Metronidazole, and Lansoprazole Triple Therapy Compared to Quadruple Therapy as a Second-Line Treatment of Helicobacter pylori Infection in Korea

• Moon JY
• Kim GH
• You HS
• Lee BE
• Ryu DY
• Cheong JH
• Jung JI
• Jeong JH
• Song CS
• Song GA

Abstract

BACKGROUND/AIMS
Several 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.
METHODS
In 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.
RESULTS
According 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.
CONCLUSIONS
LML 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.

Keyword

Helicobacter pylori; Therapeutics; Failure; Levofloxacin; Metronidazole

MeSH Terms

2-Pyridinylmethylsulfinylbenzimidazoles
Bismuth
Helicobacter
Helicobacter pylori
Humans
Korea
Metronidazole
Ofloxacin
Organometallic Compounds
Tetracycline
2-Pyridinylmethylsulfinylbenzimidazoles
Bismuth
Metronidazole
Ofloxacin
Organometallic Compounds
Tetracycline