{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T13:55:30Z","timestamp":1762005330769,"version":"3.41.2"},"reference-count":37,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2021,8,12]],"date-time":"2021-08-12T00:00:00Z","timestamp":1628726400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100011913","name":"Kaohsiung Veterans General Hospital","doi-asserted-by":"publisher","award":["VGHKS 108\u2010105"],"award-info":[{"award-number":["VGHKS 108\u2010105"]}],"id":[{"id":"10.13039\/501100011913","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Helicobacter"],"published-print":{"date-parts":[[2021,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The Maastricht V\/Florence Consensus Report recommends amoxicillin\u2010fluoroquinolone triple or quadruple therapy as a second\u2010line treatment for <jats:italic>Helicobacter pylori<\/jats:italic> infection. An important caveat of amoxicillin\u2010fluoroquinolone rescue therapy is poor eradication efficacy in the presence of fluoroquinolone resistance. The study aimed to investigate the efficacies of tetracycline\u2010levofloxacin (TL) quadruple therapy and amoxicillin\u2010levofloxacin (AL) quadruple therapy in the second\u2010line treatment of <jats:italic>H<\/jats:italic>.<jats:italic>\u00a0pylori<\/jats:italic> infection.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Consecutive <jats:italic>H<\/jats:italic>. <jats:italic>pylori<\/jats:italic>\u2010infected subjects after the failure of first\u2010line therapies were randomly allocated to receive either TL quadruple therapy (tetracycline 500\u00a0mg QID, levofloxacin 500\u00a0mg QD, esomeprazole 40\u00a0mg BID, and tripotassium dicitrato bismuthate 300\u00a0mg QID) or AL quadruple therapy (amoxicillin 500\u00a0mg QID, levofloxacin 500\u00a0mg QD, esomeprazole 40\u00a0mg BID, and tripotassium dicitrato bismuthate 300\u00a0mg QID) for 10\u00a0days. Post\u2010treatment <jats:italic>H<\/jats:italic>.<jats:italic>\u00a0pylori<\/jats:italic> status was assessed 6\u00a0weeks after the end of therapy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The study was early terminated after an interim analysis. In the TL quadruple group, 50 out of 56 patients (89.3%) had successful eradication of <jats:italic>H<\/jats:italic>.<jats:italic>\u00a0pylori<\/jats:italic> infection. Cure of <jats:italic>H<\/jats:italic>.<jats:italic>\u00a0pylori<\/jats:italic> infection was achieved only in 39 of 52 patients (69.6%) receiving AL quadruple therapy. Intention\u2010to\u2010treat analysis showed that TL quadruple therapy achieved a markedly higher eradication rate than AL quadruple therapy (95% confidence interval: 4.8% to 34.6%; <jats:italic>p<\/jats:italic>\u00a0=\u00a00.010). Further analysis revealed that TL quadruple therapy had a high eradication rate for both levofloxacin\u2010susceptible and resistant strains (100% and 88.9%). In contrast, AL quadruple therapy yielded a high eradication for levofloxacin\u2010susceptible strains (90.9%) but a poor eradication efficacy for levofloxacin\u2010resistant strains (50.0%). The two therapies exhibited comparable frequencies of adverse events (37.5% vs 21.4%) and drug adherence (98.2% vs 94.6%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Ten\u2010day TL quadruple therapy is more effective than AL quadruple therapy in the second\u2010line treatment of <jats:italic>H<\/jats:italic>. <jats:italic>pylori<\/jats:italic> infection in a population with high levofloxacin resistance.<\/jats:p><\/jats:sec>","DOI":"10.1111\/hel.12840","type":"journal-article","created":{"date-parts":[[2021,8,13]],"date-time":"2021-08-13T05:29:56Z","timestamp":1628832596000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Tetracycline\u2010levofloxacin versus amoxicillin\u2010levofloxacin quadruple therapies in the second\u2010line treatment of <i>Helicobacter pylori<\/i> infection"],"prefix":"10.1111","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3905-4674","authenticated-orcid":false,"given":"Ping\u2010I","family":"Hsu","sequence":"first","affiliation":[{"name":"Division of Gastroenterology and Hepatology Department of Internal Medicine An Nan Hospital China Medical University Tainan Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Feng\u2010Woei","family":"Tsay","sequence":"additional","affiliation":[{"name":"Kaohsiung Veterans General Hospital and National Yang\u2010Ming University Kaohsiung Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John Y.","family":"Kao","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology Department of Internal Medicine Michigan Medicine University of Michigan Ann Arbor Michigan USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nan\u2010Jing","family":"Peng","sequence":"additional","affiliation":[{"name":"Department 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Siaogang Hospital Kaohsiung Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sung\u2010Shuo","family":"Kao","sequence":"additional","affiliation":[{"name":"Kaohsiung Veterans General Hospital and National Yang\u2010Ming University Kaohsiung Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Huay\u2010Min","family":"Wang","sequence":"additional","affiliation":[{"name":"Kaohsiung Veterans General Hospital and National Yang\u2010Ming University Kaohsiung Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"I\u2010Ting","family":"Wu","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology Department of Internal Medicine An Nan Hospital China Medical University Tainan Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chang\u2010Bih","family":"Shie","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology Department of Internal Medicine 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