Levofloxacin, Metronidazole, and Lansoprazole Triple Therapy Compared to Quadruple Therapy as a Second-Line Treatment of Helicobacter pylori Infection in Korea.
- Author:
Ji Yoon MOON
1
;
Gwang Ha KIM
;
Hyun Seok YOU
;
Bong Eun LEE
;
Dong Yeop RYU
;
Jae Hoon CHEONG
;
Jung Im JUNG
;
Jae Hoon JEONG
;
Chul Soo SONG
;
Geun Am SONG
Author Information
1. Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea. doc0224@pusan.ac.kr
- Publication Type:Original Article ; Randomized Controlled Trial
- Keywords:
Helicobacter pylori;
Therapeutics;
Failure;
Levofloxacin;
Metronidazole
- MeSH:
2-Pyridinylmethylsulfinylbenzimidazoles;
Bismuth;
Helicobacter;
Helicobacter pylori;
Humans;
Korea;
Metronidazole;
Ofloxacin;
Organometallic Compounds;
Tetracycline
- From:Gut and Liver
2013;7(4):406-410
- CountryRepublic of Korea
- Language:English
-
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.
