title: Levofloxacin-containing second-line anti-Helicobacter pylori eradication in Taiwanese real-world practice.
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%).
  
  
  CONCLUSIONS
  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.
authors.forename: Chih-Ming
authors.initials: CM
authors.lastname: Liang
authors.forename: Jen-Wen
authors.initials: JW
authors.lastname: Cheng
authors.forename: Chung-Mou
authors.initials: CM
authors.lastname: Kuo
authors.forename: Kuo-Chin
authors.initials: KC
authors.lastname: Chang
authors.forename: Keng-Liang
authors.initials: KL
authors.lastname: Wu
authors.affiliation: Division of Hepatogastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
authors.forename: Wei-Chen
authors.initials: WC
authors.lastname: Tai
authors.forename: King-Wah
authors.initials: KW
authors.lastname: Chiu
authors.forename: Shue-Shian
authors.initials: SS
authors.lastname: Chiou
authors.forename: Ming-Tsung
authors.initials: MT
authors.lastname: Lin
authors.forename: Tsung-Hui
authors.initials: TH
authors.lastname: Hu
authors.forename: Seng-Kee
authors.initials: SK
authors.lastname: Chuah
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000658:Amoxicillin / Q000494:pharmacology*; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D044466:Asian People; D017291:Clarithromycin / Q000627:therapeutic use; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination / Q000379:methods; D064098:Esomeprazole / Q000627:therapeutic use; D005260:Female; D016481:Helicobacter Infections / Q000188:drug therapy*; D016480:Helicobacter pylori / Q000187:drug effects*; D006801:Humans; D064704:Levofloxacin / Q000627:therapeutic use*; D008297:Male; D008795:Metronidazole / Q000627:therapeutic use; D008875:Middle Aged; D013624:Taiwan; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D008795:Metronidazole; D064704:Levofloxacin; D000658:Amoxicillin; D017291:Clarithromycin; D064098:Esomeprazole