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  • In H. pylori- infected patients second-line treatment with sequential levofloxacin therapy was more effective than levofloxacin triple therapy but was still suboptimal

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Therapeutics/Prevention
Randomised controlled trial
In H. pylori- infected patients second-line treatment with sequential levofloxacin therapy was more effective than levofloxacin triple therapy but was still suboptimal
  1. Adrian G McNicholl,
  2. Javier P Gisbert
  1. Gastroenterology Unit, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-IP), Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Madrid, Spain
  1. Correspondence to : Dr Javier P Gisbert, Gastroenterology Unit, Hospital de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-IP), Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), c/ Diego de León 62, Madrid 28006, Spain; Javier.p.gisbert{at}gmail.com

https://doi.org/10.1136/ebmed-2016-110458

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    Commentary on: Liou JM, Bair MJ, Chen CC, et al. Levofloxacin sequential therapy vs levofloxacin triple therapy in the second-line treatment of Helicobacter pylori: a randomized trial. Am J Gastroenterol 2016;111:381–7OpenUrlCrossRefPubMed.

    Context

    Helicobacter pylori infection is the main cause of several gastric diseases including gastritis, peptic ulcer and gastric cancer. Traditional anti-H. pylori treatments fail in up to 20–30% of naive patients requiring intervention. Failed attempts may cause the acquisition of resistance by H. pylori or the selection of resistant/resilient strains, hindering second-line treatments.

    One of the most recommended second-line regimens is triple therapy with levofloxacin (LT); however, its efficacy has never been optimal, with an estimated pooled eradication rate of 79%.1 In order to improve these results, Liou and colleagues performed a randomised trial comparing LT with a levofloxacin containing sequential therapy (LS).

    Methods

    The study was …

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    Footnotes

    • Contributors AGM drafted the manuscript, and JPG critically reviewed it.

    • Competing interests AGM has received funds for a scientific oral presentation in one event promoted by Allergan. JPG has received funds to promote research from – and/or has provided advisory and education activities to – Almirall, Allergan, AstraZeneca, Casen Recordati, Nycomed.

    • Provenance and peer review Commissioned; internally peer reviewed.