Levofloxacin based triple therapy as a second-line treatment after failure of Helicobacter pylori eradication with standard triple therapy

Background. Successful eradication of Helicobacter pylori infection after failure of standard triple therapy is difficult. The efficacy and safety of levofloxacin based triple therapy as a first-line therapy has been studied. Aims. The aim was to evaluate the efficacy and tolerability of levofloxacin based therapy after a failed standard triple therapy. Patients. We conducted a prospective, uncontrolled study of a consecutive series of 33 patients who failed eradication with I week of lansoprazole-amoxicillin-clarithromycin triple therapy. Methods. The subjects were retreated with I week of LA-LVFX triple therapy (lansoprazole, 30 mg twice daily; amoxicillin, 1000 mg twice daily; levofloxacin, 200 mg twice daily). Cure of infection was defined as negative results from culture, histology and a urea breath test 4 to 8 weeks after the second-line therapy. Results. The eradication rate was 69.7% (23/33) by both intention-to-treat and per-protocol analyses (95% confidence interval = 61-79%). Seven (21.2%) patients experienced mild side-effects, such as soft stools and taste disturbance. No patient stopped the medication on account of adverse effects. Conclusions. Levofloxacin based triple therapy is an effective second-line treatment after a failed standard triple therapy. (C) 2003 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.