Efficacy of levofloxacin and bismuth-containing quadruple therapy for the eradication of Helicobacter pylori

Objective To evaluate the efficacy and safety of the 10-day levofloxacin and bismuth-containing quadruple therapy as first-line therapy for the eradication of Helicobacter pylori. Methods A total of 150 patients with H.pylori infection were enrolled and randomly assigned into triple and quadruple group.The patients in the triple therapy group received esomeprazole 20 mg bid,clarithromycin 500 mg bid and amoxicillin 1.0 g bid for seven days.The patients in the quadruple therapy group received esomeprazole 20 mg bid,pectin bismuth 200 mg bid,levofloxacin 500 mg qd,amoxicillin 1.0 g bid for ten days. H. pylori eradication was assessed by 13C-urea breath test six weeks after cessation of therapy,and the safety was also evaluated.Results The intention-to-treat (ITT) and per-protocol (PP)eradication rates were 73.3% and 75.3% in the triple group, and 93.3% and 95.9% in the quadruple group, respectively. The eradication rate was significantly higher in the quadruple group compared with the triple group in both the ITT and PP populations (P0.01), whereas the incidence of adverse events was similar.No serious adverse reactions occurred.Conclusion The 10-day levofloxacin and bismuth-containing quadruple therapy as first-line therapy can achieve a higher eradication rate than the 7-day standard triple therapy in the initial treatment of H.pylori infection.