Ten-Day versus 14-Day Levofloxacin-Containing Triple Therapy for Second-Line Anti-Helicobacter pylori Eradication in Taiwan

Abstract EN

Second-line Helicobacter pylori (H.

pylori) eradication with fluoroquinolone-containing triple therapy is one of the recommended treatment options, but neither 7-day nor 10-day regimens provide >90% success rates.

The current retrospective study aimed to clarify the effects of 10-day and 14-day levofloxacin-containing triple therapies for second-line H.

pylori eradication in a Taiwanese cohort and to evaluate the potential clinical factors influencing eradication.

A total of 200 patients who failed H.

pylori eradication using the standard triple therapy were prescribed with either a 10-day (EAL-10) or a 14-day (EAL-14) levofloxacin-containing triple therapy group (levofloxacin 500 mg once daily, amoxicillin 1 g twice daily, and esomeprazole 40 mg twice daily).

Follow-up studies to assess treatment response were carried out 8 weeks later.

Eradication rates attained by EAL-10 and EAL-14 were 75.6%; 95% CI=63.9–85.3% and 92.5%; 95% CI=84.5–98.1%, P=0.002 in the per protocol analysis and 68%; 95% CI=56.6–78.5% and 86%; 95% CI=76.8–93.4%, P=0.002 in the intention-to-treat analysis.

The duration of H.

pylori therapy is the independent risk factor of H.

pylori eradication (P=0.003).

In conclusion, 14-day levofloxacin-containing triple therapy can provide a >90% H.

pylori eradication rate, but 10-day treatment duration may be suboptimal.

The longer duration of H.

pylori therapy (14 days) is the independent risk factor.