Sequential vs. Standard Levofloxacin-Based Second-Line Therapy for H. pylori

As antibiotic resistance increases, successful Helicobacter pylori eradication decreases. Levofloxacin-based triple therapy has been recommended as second-line H. pylori eradication therapy. However, its success rate in areas of increasing levofloxacin resistance has fallen to less than 80%.

To determine if second-line levofloxacin is more effective as sequential therapy than as standard triple therapy, investigators in Taiwan conducted a prospective, multicenter, randomized, open-label study involving 600 patients who failed primary clarithromycin-based H. pylori eradication. Data on 187 patients showed baseline resistance rates of 59.9% with clarithromycin, 17.6% with levofloxacin, 36.9% with metronidazole, 1.1% with amoxicillin, and 3.7% …