To evaluate a levoﬂoxacin-doxycycline-based triple therapy with or without a susceptibility culture test in non-responders to Helicobacter pylori (H. pylori) eradication.
A total of 142 (99 women, 43 men; mean 53.0 ± 12.7 years) non-responders to more than two H. pylori eradication therapies underwent susceptibility culture tests or were treated with a seven-day triple therapy consisting of esomeprazole, 20 mg b.i.d., levoﬂoxacin, 500 mg b.i.d., and doxycycline, 100 mg b.i.d., randomly associated with (n = 71) or without (n = 71) Lactobacillus casei DG. H. pylori status was checked in all patients at enrollment and at least 8 weeks after the end of therapy. Compliance and tolerability of regimens were also assessed.
H. pylori eradication was achieved in < 50% of patients [per protocol (PP) = 49%; intention to treat (ITT) = 46%]. Eradication rate was higher in patients administered probiotics than in those without (PP = 55% vs 43%; ITT = 54% vs 40%). Estimated primary resistance to levoﬂoxacin was 18% and multiple resistances were 31%. Therapy was well tolerated, and side eﬀects were generally mild, with only one patient experiencing severe eﬀect.
Third-line levoﬂoxacin-doxycycline triple therapy had a low H. pylori eradication eﬃcacy, though the success and tolerability of this treatment may be enhanced with probiotics.
Paoluzi OA, Del Vecchio Blanco G, Visconti E, Coppola M, Fontana C, Favaro M, Pallone F.
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