Comparison of the Levofloxacin Sequential Therapy and Quadruple Therapy in Second Line Treatment for HP
Status:
Unknown status
Trial end date:
2019-04-01
Target enrollment:
Participant gender:
Summary
Objectives: Eradication of H. pylori infection could reduce the occurence or recurrence of
gastric cancer and peptic ulcer diseases. However, it was estimated that 15-20% of patients
would fail from first line standard eradication therapy and need second line rescue therapy.
About 15-30% of patient would fail from second line therapy. Bismuth quadruple therapy and
triple therapy containing levofloxacin are currently the recommended rescue therapies in the
second line and third line treatment. Recently, our pilot study showed that modified
sequential therapy containing levofloxacin achieved high eradication rate (95%) in the second
line therapy. The regimen includes a PPI plus amoxicillin for 5-7 days, followed by a PPI
plus levofloxacin and metronidazole for another 5-7 days. However, whether this modified
sequential therapy containing levofloxacin is more effective than bismuth quadruple therapy
in the second line and third line treatment remains unknown. Besides, the impact of these
regimens on the antibiotic resistance , microbiota of gut flora, and metabolic factors
remains unknown.
Aims: Therefore, the investigators aimed to
1. compare the eradication rates and long term re-infection rates of sequential therapy
containing levofloxacin for 14 days versus bismuth quadruple therapy for 10 days in the
second line and third line treatment
2. assess the impact of antibiotic resistance and CYP2C19 polymorphism on the eradication
rate of these regimens
3. assess the impact of these eradication regimens on the antibiotic resistance and
microbiota of the gut flora
4. assess the impact of eradication therapy on the metabolic factors