Trial reportThe American journal of gastroenterology2017
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.
Trial report in The American journal of gastroenterology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers, 1 of them a synthesis that pooled it.
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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
28 citing papers in PubMed, 1 synthesis or guideline pooled it, 41 citations in OpenAlex.
- Evidence-based clinical practice guidelines for peptic ulcer disease 2020.Journal of gastroenterology · 2021Guideline
- Rech. f. & Esfand as adjunctive therapy for eradication: a randomized controlled trial.Journal of traditional Chinese medicine = Chung i tsa chih ying wen pan · 2025Trial
- Efficacy and Safety of Antofloxacin-Based Triple Therapy for Helicobacter pylori Eradication Failure in China.Digestive diseases and sciences · 2022Trial
- Trial
- Review
- Third-Line and Later Susceptibility-GuidedJournal of clinical medicine · 2026Article
- Advances in the Management of RefractoryGastro hep advances · 2026Review
- Research progress of potassium-competitive acid blockers in the treatment ofAnnals of medicine · 2025Review
- Anti-Helicobacter pylori Infection Treatment and Pulmonary Hypersensitivity: Case Series and Review of the Literature.The clinical respiratory journal · 2024Review
- Efficacy and tolerability ofHealth science reports · 2024Article
- Review
- Application of artificial intelligence in endoscopic image analysis for the diagnosis of a gastric cancer pathogen-Helicobacter pylori infection.Scientific reports · 2023Article
- Update on the second-line treatment ofTherapeutic advances in gastroenterology · 2023Review
- Levofloxacin+Tetracycline Quadruple Regimen for Eradication ofMiddle East journal of digestive diseases · 2023Article
- Egg yolk antibody combined with bismuth-based quadruple therapy inFrontiers in microbiology · 2023Article
- Treatment of refractoryFrontiers in microbiology · 2022Review
- The efficacies of non-bismuth containing quadruple therapies in the treatment of first-line anti-Helicobacter pylori across 4-year time interval with changing antibiotics resistance.Biomedical journal · 2021Article
- Revisiting Therapeutic Strategies forMolecules (Basel, Switzerland) · 2021Review
- Resistance pattern ofIranian journal of microbiology · 2020Article
- Update on quinolone-containing rescue therapies forWorld journal of gastroenterology · 2020Review
Corrections and comments
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Authors and funding
12 authors at 6 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesProton pump inhibitor (PPI)-amoxicillin-fluoroquinolone triple therapy is recommended as a second-line treatment of Helicobacter pylori infection in the Maastricht V/Florence Consensus Report. However, the eradication rate of this standard salvage treatment is suboptimal. The objective of this study is to compare the efficacy of esomeprazole-bismuth-tetracycline-levofloxacin therapy (TL quadruple therapy) and esomeprazole-amoxicillin-levofloxacin triple therapy (AL triple therapy) in rescue treatment for H. pylori infection.
methodsConsecutive H. pylori-infected subjects after failure of first-line therapies were randomly allocated to receive either TL quadruple therapy (esomeprazole 40 mg b.d., bismuth 120 mg q.d.s., tetracycline 500 mg q.d.s., and levofloxacin 500 mg o.d.) or AL triple therapy (esomeprazole 40 mg b.d., amoxicillin 500 mg q.d.s., and levofloxacin 500 mg o.d.) for 10 days. H. pylori status was assessed 6 weeks after the end of treatment.
resultsThe study was stopped after an interim analysis. Of 50 patients in the TL quadruple therapy, 49 (98.0%) had successful eradication of H. pylori infection. Cure of H. pylori infection was achieved in 36 of 52 patients (69.2%) receiving AL triple therapy. Intention-to-treat analysis demonstrated that TL quadruple therapy achieved a markedly higher eradication rate than AL triple therapy (difference: 28.8%; 95% confidence interval: 15.7% to 41.9%; P<0.001). Per-protocol analysis yielded a similar result (97.8% vs. 68.6%; P<0.001). The two treatment groups exhibited comparable frequencies of overall adverse events (22.0% vs. 11.5%) and drug compliance (90.0% vs. 98.1%). The subgroup analysis showed that TL quadruple therapy was superior to AL triple therapy in patients with failure of either standard triple therapy (100% vs. 75.0%; P=0.010) or non-bismuth quadruple therapy (95.0% vs. 52.6%; P=0.003).
conclusionsTen-day PPI-bismuth-tetracycline-levofloxacin quadruple therapy is a good option for rescue treatment of H. pylori infection following failure of standard triple or non-bismuth quadruple therapy.
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Registered trials
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