Trial reportHelicobacter2013
Effect of fluoroquinolone resistance on 14-day levofloxacin triple and triple plus bismuth quadruple therapy.
Trial report in Helicobacter, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 36 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
36 citing papers in PubMed, 3 syntheses or guidelines pooled it, 110 citations in OpenAlex.
- Pooled it
- Pooled it
- Pooled it
- Can the treatment duration be shortened in bismuth-containing therapies for Helicobacter pylori eradication?The Turkish journal of gastroenterology : the official journal of Turkish Society of Gastroenterology · 2019Trial
- Efficacy of two different dosages of levofloxacin in curing Helicobacter pylori infection: A Prospective, Single-Center, randomized clinical trial.Scientific reports · 2018Trial
- Ten-Day Quadruple Therapy Comprising Proton Pump Inhibitor, Bismuth, Tetracycline, and Levofloxacin is More Effective than Standard Levofloxacin Triple Therapy in the Second-Line Treatment of Helicobacter pylori Infection: A Randomized Controlled Trial.The American journal of gastroenterology · 2017Trial
- Randomized Clinical Trial: Esomeprazole, Bismuth, Levofloxacin, and Amoxicillin or Cefuroxime as First-Line Eradication Regimens for Helicobacter pylori Infection.Digestive diseases and sciences · 2017Trial
- Comparison of Helicobacter pylori Eradication Rates of 2-Week Levofloxacin-Containing Triple Therapy, Levofloxacin-Containing Bismuth Quadruple Therapy, and Standard Bismuth Quadruple Therapy as a First-Line Regimen.Medical principles and practice : international journal of the Kuwait University, Health Science Centre · 2017Trial
- Efficacy and Safety of Modified Bismuth Quadruple Therapy for First-LineMicroorganisms · 2025Review
- Comparison of tegoprazan-based high-dose dual therapy versus bismuth-containing quadruple therapy forTherapeutic advances in gastroenterology · 2025Article
- Fourteen-day vonoprazan-amoxicillin dual therapy versus 14-day bismuth-based quadruple therapy forTherapeutic advances in gastroenterology · 2025Article
- Evolution of the use, effectiveness and safety of bismuth-containing quadruple therapy forGut · 2024Observational
- Diagnostic and therapeutic recommendations onPrzeglad gastroenterologiczny · 2023Article
- Update on the second-line treatment ofTherapeutic advances in gastroenterology · 2023Review
- Primary Antibiotic Resistance ofPathogens (Basel, Switzerland) · 2022Review
- Levofloxacin versus clarithromycin for Helicobacter pylori eradication: are 14 day regimens better than 10 day regimens?Gut pathogens · 2022Article
- Primer for Development of Guidelines for Helicobacter pylori Therapy Using Antimicrobial Stewardship.Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association · 2022Review
- Experience with Rifabutin-Containing Therapy in 500 Patients from the European Registry onJournal of clinical medicine · 2022Article
- Sitafloxacin for Third-LineJournal of clinical medicine · 2021Review
- Rifabutin for the Treatment ofPathogens (Basel, Switzerland) · 2020Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors at 3 institutions in 2 countries.
Funding
Abstract
objectiveLevofloxacin has been proposed to replace clarithromycin for Helicobacter pylori treatment. Seven- and 10-day fluoroquinolone triple therapies have generally failed to achieve cure rates of ≥90%, whereas 14-day therapy has achieved 95% success. The aim was to assess the efficacy and effect of fluoroquinolone resistance on 14-day levofloxacin-containing triple therapy with or without the addition of bismuth.
designHelicobacter pylori-positive patients with functional dyspepsia or healed peptic ulcers were randomized to receive lansoprazole 30 mg b.i.d., amoxicillin 1000 mg b.i.d., and levofloxacin 500 mg daily with (B-LAL) or without (LAL) bismuth potassium citrate 220 mg b.i.d. for 14 days. Eradication was assessed by ¹³C-urea breath testing 4 weeks after completing treatment. Antimicrobial susceptibility was by the agar dilution method. Success was defined as PP success ≥90%.
resultsA total of 152 of 161 patients (81 LAL and 80 B-LAL) enrolled completed treatment. The PP rates were 94.6% (70/74; 95% CI, 86.9-97.9%) with B-LAL and 85.9% (95% CI, 76.5-91.9%) with LAL (p = .07); the ITT eradication rates were 87.5% (95% CI, 78.5-93.1%) with B-LAL and 82.7% (95% CI, 73-89.4%) with LAL (p = .39). Levofloxacin resistance was present in 30.3%. Treatment success was excellent with susceptible strains (97.5%) versus resistant strains (70.6%) for B-LAL and 97.3% versus 37.5% for LAL, respectively.
conclusionsFourteen-day fluoroquinolone therapy was highly effective when fluoroquinolone resistance rates are <12%. The addition of bismuth maintained effectiveness with fluoroquinolone resistance as high as 25%.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.