Levofloxacin-containing Therapies In Second Line Helicobacter Pylori Eradication

In this randomized-controlled trial , the investigator recruited participants with H pylori infection after failure of first line standard triple therapy. Using a computer-generated randomization sequence, the investigators randomly allocated patients to either 10-day levofloxacin-containing sequential (EALM, esomeprazole 40 mg b.d., amoxicillin 1 g b.d.for 5 days and followed by esomeprazole 40 mg b.d., levofloxacin 500 mg qd and metronidazole for 5 days) or 10-day levofloxacin-containing triple therapy (EAL, esomeprazole 40 mg b.d., amoxicillin 1 g b.d., and levofloxacin 500 mg qd) at a 1:1 ratio. The primary outcome was the eradication rate by intention-to-treat and per-protocol analyses.

Inclusion criteria

• Consecutive H. pylori-infected participants, at least 18 years of age, with endoscopically proven peptic ulcer diseases or gastritis who failed first-line eradication therapies with standard triple regimens (PPI twice daily, 500 mg of clarithromycin twice daily and 1 g of amoxicillin twice daily)

Exclusion criteria

• Ingestion of antibiotics, bismuth, or proton-pump inhibitors within the prior 4 weeks
• Use of non-steroidal anti-inflammatory drugs within the prior 4 weeks
• Participants with allergic history to the medications used
• Participants with previous gastric surgery
• The coexistence of serious concomitant illness (for example, decompensated liver cirrhosis, uremia)
• Pregnant women.