Related Experiment Video
Updated: Dec 18, 2025
Detection of Helicobacter pylori Infection and Antibiotic Resistance via Stool Quantitative Polymerase Chain Reaction Analysis
Published on: May 16, 2025
Efficacy and tolerability of a third-line, levofloxacin-based, 10-day sequential therapy in curing resistant
Antonio Tursi1, Marcello Picchio, Walter Elisei
1Gastroenterology Service Territoriale, ASL BAT, Andria-BT, Italy. antotursi@tiscali.it
Background And Aims:
Failure in the eradication of H. pylori is a frequent occurrence. We assessed the effectiveness of a third-line, levofloxacin-containing, 10-day sequential treatment, in order to obtain eradication of H. pylori resistant patients in a clinical setting.
Methods:
One-hundred and nineteen consecutive patients with proven two consecutive failures in curing H. pylori infection, containing either clarithromycin, bismuth or levofloxacin, were prospectively assessed. All patients received a 10-day sequential therapy with proton pump inhibitor (PPI) plus amoxicillin 1 g for the first 5 days, followed by PPI, levofloxacin 500 mg and tetracycline 500 mg for the remaining 5 days (all twice daily). One month after conclusion of therapy, endoscopy was performed in those patients for whom the examinations were clinically relevant. The remaining patients were checked by ¹³C-urea breath test.
Results:
H. pylori eradication was obtained in 80 patients (per-protocol: 68.38%; on intention-to-treat: 67.23%). Twenty-nine patients (24.37%) experienced side-effects, but only two of them (1.68%) were withdrawn from the study.
Conclusion:
A 10-day sequential triple therapy containing amoxicillin, levofloxacin and tetracycline seems to be effective and safe in curing resistant H. pylori infection.
Related Concept Videos
01:28Acute Pyelonephritis II: Diagnostic Studies and Management
01:16Treating Helicobacter pylori in Peptic Ulcers: Antimicrobial Therapy
01:26Peptic Ulcer Disease IV: Management
The therapeutic approach involves ensuring adequate rest, implementing drug therapy, promoting smoking cessation, making dietary modifications, and emphasizing long-term follow-up care.
Pharmacological management
The prevailing therapy for peptic ulcers involves a combination of managing the patient's current...
01:28Peptic Ulcer Disease III: Clinical Manifestations and Diagnostic Studies
Few clinical manifestations differentiate gastric ulcers from duodenal ulcers. Distinctions in the location, timing, and pain relief are crucial for healthcare providers in differentiating between gastric and duodenal ulcers during clinical assessments.
01:28Pulmonary Tuberculosis V
Latent tuberculosis infection occurs when TB bacteria are present in a person's body, but are not causing illness or symptoms. It is not contagious, and preventive treatment is crucial to avoid the...
01:23Gastritis III: Clinical Manifestations and Management
Clinical manifestations of acute gastritis
The patient with acute gastritis may have a rapid onset of symptoms, such as epigastric pain or discomfort, dyspepsia, anorexia, hiccups, or nausea and vomiting, which can last from a few hours to a few days. Erosive or hemorrhagic gastritis may cause bleeding, which may manifest as blood in vomit or as...