Efficacy of Bismuth-Based Quad Tx vs Levofloxacin Triple Tx for H pylori

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.

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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