Efficacy of Bismuth-Based Quad Tx vs Levofloxacin Triple Tx for H pylori
Most cases of eradication failure were levofloxacin resistant.
HealthDay News — For patients with Helicobacter pylori infection, the addition of bismuth subcitrate to levofloxacin-based triple therapy is not associated with increased effectiveness, although there are no more side effects, according to a study published in the Journal of Digestive Diseases.
Tzung-Shiun Wu, from the Kaohsiung Medical University Hospital in Taiwan, and colleagues conducted a prospective study involving 67 patients infected with H pylori. Patients were randomized to receive levofloxacin plus bismuth-based quadruple therapy (RBAL) for 10 days (33 patients) or levofloxacin-based triple therapy (RAL) for 10 days (34 patients). The response was assessed using endoscopy performed 4 to 8 weeks after eradication.
The researchers found that both groups showed similar eradication rates (84.8% and 67.6% for RBAL and RAL, respectively; P =.373) in intention-to-treat analysis. There was no significant difference in compliance (P =1.031); adverse events were also similar between the groups. Most cases of eradication failure were levofloxacin resistant.
"Levofloxacin-resistant rate may be a more important role when choosing second-line therapy," the authors write.
Wu TS, Hsu PI, Kuo CH, et al. Comparison of 10 days levofloxacin bismuth based quadruple therapy and levofloxacin based triple therapy for Helicobacter pylori therapy [published online June 23, 2017]. J Dig Dis. doi: 10.1111/1751-2980.12498