[Second-line therapy for patients with Helicobacter pylori eradication failure]

Meta-analyses showed that quadruple therapy, ranitidine bismuth-based triple therapy and levofloxacin-based triple therapy were the most effective for the second-line H. pylori eradication therapy. In Japan, many studies showed that triple therapy with proton pump inhibitor (PPI), amoxicillin (AMPC) and metronidazole was effective after eradication failure using triple therapy with PPI, AMPC and clarithromycin. The intention-to-treat eradication rates were 81-97%, and the incidence rates of adverse events were 8-33%.