Efficacy of Levofloxacin-based Triple Therapy Combined with Probiotics as A Rescue Therapy for Helicobacter pylori Re-eradication / 胃肠病学

ABSTRACT

Background:With the emergence of bacterial resistance,the efficacy of Helicobacter pylori(Hp)eradication therapy is decreasing in recent years. After the previous failed course of eradication therapy,the possibility of failure of re-eradication therapy is greater. Therefore,choosing the rescue therapy for Hp re-eradication is particularly important. Aims:To investigate the efficacy of levofloxacin-based triple therapy combined with probiotics as a rescue therapy for Hp re-eradication. Methods:A total of 192 patients with a previous failed course of standard triple therapy for Hp eradication were enrolled and randomly assigned into four groups. Group Alansoprazole 30 mg + amoxicillin 1 000 mg + levofloxacin 200 mg bid for 14 days;group Bregimen of group A with the addition of bismuth potassium citrate 600 mg bid for 14 days;group Cbifidobacterium and lactobacillus triple live bacteria 2 000 mg tid for 14 days followed by regimen of group A for 14 days;group Dregimen of group A with the addition of bifidobacterium and lactobacillus triple live bacteria 2 000 mg tid for 14 days. At 4 weeks after end of treatment,Hp eradication was assessed by 13 C-urea breath test. Adverse effects during the course of treatment were recorded. Results:A total of 177(92. 2% )patients completed the study,the completion rates in group A,B,C and D were 87. 5%(42 / 48),83. 3%(40 / 48),97. 9%(47 / 48)and 100% , respectively;the completion rates in group C and D were significantly higher than those in group A and B(P 0. 05). Adverse effects included constipation,taste distortion,bloating and anorexia,the incidences of adverse effects in group A,B,C and D were 79. 2% ,95. 8% ,29. 2% and 22. 9% ,respectively;the incidences in group C and D were significantly lower than those in group A and B(P < 0. 05). Conclusions:Levofloxacin-based triple therapy combined with bifidobacterium and lactobacillus triple live bacteria can decrease the adverse effects of traditional triple and quadruple therapies and improve the patient compliance,thus increases the efficacy of rescue therapy for Hp re-eradication.