title: Clinical trial: levofloxacin-based quadruple therapy was inferior to traditional quadruple therapy in the treatment of resistant Helicobacter pylori infection.
abstract: BACKGROUND
  The efficacy of levofloxacin-based quadruple therapy in resistant Helicobacter pylori infection is not known.
  
  
  OBJECTIVE
  To test the efficacy of levofloxacin-based quadruple therapy and traditional quadruple therapy in resistant H. pylori infection.
  
  
  METHODS
  One hundred and two patients with resistant H. pylori infection were randomized to 1 week of either EBAL (esomeprazole 40 mg b.d., bismuth subcitrate 240 mg b.d., amoxicillin 1 g b.d. and levofloxacin 500 mg b.d.) or EBMT (esomeprazole 40 mg b.d., bismuth subcitrate 240 mg b.d., metronidazole 400 mg t.d.s. and tetracycline 500 mg q.d.s.). (13)C-urea breath test was performed at week 12 to assess post-treatment H. pylori status.
  
  
  RESULTS
  In intention-to-treat analysis H. pylori eradication was achieved in 37 of 51 (73%) subjects in EBAL and 45 of 51 (88%) subjects in EBMT groups, respectively (P = 0.046). Per-protocol eradication rates of EBAL and EMBT groups were 78% and 94%, respectively (P = 0.030). The intention-to-treat eradication rate was statistically lower for EBAL than EMBT (56% vs. 90%, P = 0.013) among those who had failed more than one course of eradication therapy. Previous levofloxacin triple therapy did not affect the efficacy of either protocol significantly.
  
  
  CONCLUSIONS
  Levofloxacin-based quadruple therapy was inferior to traditional quadruple therapy for resistant H. pylori infection.
authors: Department of Medicine, University of Hong Kong, Kong Kong.
authors: Y K
authors: YK
authors: Yee
authors: T K
authors: TK
authors: Cheung
authors: K-M
authors: KM
authors: Chu
authors: C K
authors: CK
authors: Chan
authors: J
authors: J
authors: Fung
authors: P
authors: P
authors: Chan
authors: D
authors: D
authors: But
authors: I
authors: I
authors: Hung
authors: A O O
authors: AO
authors: Chan
authors: M F
authors: MF
authors: Yuen
authors: A
authors: A
authors: Hsu
authors: B C Y
authors: BC
authors: Wong
mesh_terms: D000328:Adult; D000368:Aged; D000658:Amoxicillin / Q000494:pharmacology / Q000627:therapeutic use*; D000900:Anti-Bacterial Agents / Q000494:pharmacology / Q000627:therapeutic use*; D001944:Breath Tests; D004359:Drug Therapy, Combination; D064098:Esomeprazole / Q000494:pharmacology / Q000627:therapeutic use*; D005260:Female; D016481:Helicobacter Infections / Q000188:drug therapy* / Q000378:metabolism; D016480:Helicobacter pylori; D006801:Humans; D064704:Levofloxacin; D008297:Male; D008875:Middle Aged; D015242:Ofloxacin / Q000494:pharmacology / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D064704:Levofloxacin; D000658:Amoxicillin; D015242:Ofloxacin; D064098:Esomeprazole