Levofloxacin-containing second-line anti-Helicobacter pylori eradication in Taiwanese real-world practice

Chih Ming Liang, Jen Wen Cheng, Chung Mou Kuo, Kuo Chin Chang, Keng Liang Wu, Wei Chen Tai*, King Wah Chiu, Shue Shian Chiou, Ming Tsung Lin, Tsung Hui Hu, Seng Kee Chuah

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review

22 Scopus citations

Abstract

Background: Quinolone-containing triple therapy is recommended as an option for non-bismuth containing second-line Helicobacter pylori eradication. Current available Taiwanese reports in the literature used 7-day quinolone-containing triple therapy. As a result, some physicians still prescribe 7-day regimens in real-world practice in Taiwan. This study aimed to further assess the appropriateness of 7-day levofloxacin-containing triple therapy as second-line therapy. Methods: We enrolled 61 patients who failed H. pylori eradication using the standard triple therapy for 7 days and were prescribed levofloxacin-containing second-line triple therapy (levofloxacin 500 mg once daily, amoxicillin 1 g twice daily, and esomeprazole 40 mg twice daily). Routine follow-up with either endoscopy or urea breath test was done 8 weeks later to assess treatment response. Results: The eradication rates were 78.7% in the intention-to-treat analysis and 81% in the per-protocol analysis. The incidence of adverse events was 6.6%. Drug compliance was 95.1%. Antibiotic resistance showed the following results: Amoxicillin (0%), levofloxacin (23.5%), clarythromycin (35.3%), metronidazole (17.6%), and tetracycline (0%). Conclusion: The 7-day levofloxacin-containing triple therapy provides an unacceptable per-protocol report card as the second-line treatment for anti-H. pylori eradication in Taiwan and should be modified by either extending the duration to 10-14 days or seeking other regimens.

Original languageEnglish
Pages (from-to)326-330
Number of pages5
JournalBiomedical Journal
Volume37
Issue number5
DOIs
StatePublished - 01 09 2014

Keywords

  • 7-day levofloxacin-containing triple therapy
  • fluoroquinolone
  • second-line anti-Helicobacter pylori therapy

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