{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:31:56Z","timestamp":1787027516612,"version":"build-2736575974"},"reference-count":15,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2025,8,14]],"date-time":"2025-08-14T00:00:00Z","timestamp":1755129600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Antibiotics"],"abstract":"<jats:p>Background\/Objectives:\u00a0Helicobacter pylori (H. pylori) infection remains highly prevalent in Vietnam, associated with chronic gastritis, peptic ulcers, and gastric cancer. This study aimed to evaluate the real-world eradication rate of levofloxacin-based bismuth quadruple therapy (PALB) as second-line treatment, assess adherence, and identify associated factors with treatment success. Methods: We conducted a prospective cohort study including 225 patients with confirmed failure of classical bismuth-based quadruple therapy. All received a 14-day PALB regimen. H. pylori eradication was assessed using 13C-urea breath test and\/or rapid urease test 4\u201312 weeks after treatment. Results: Eradication rates were 78.2% (mITT) and 78.6% (PP), with 95% CIs overlapping the 80% benchmark. Adherence was high (91.6%) and significantly associated with success (OR = 2.93; 95% CI: 1.11\u20137.74; p = 0.039). No other factors were significantly associated. Conclusions: While PALB remains a valid second-line therapy, its efficacy may be declining, though not statistically inferior to 80%. Improving adherence and strengthening stewardship are essential.<\/jats:p>","DOI":"10.3390\/antibiotics14080826","type":"journal-article","created":{"date-parts":[[2025,8,14]],"date-time":"2025-08-14T15:44:21Z","timestamp":1755186261000},"page":"826","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Diminishing Efficacy of Second-Line Levofloxacin-Based Quadruple Therapy in Helicobacter pylori Eradication: A Prospective Real-World Study in Vietnam Amid Rising Antibiotic Resistance"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4151-7861","authenticated-orcid":false,"given":"Thong Duy","family":"Vo","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, School of Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City 71724, Vietnam"},{"name":"Department of Gastroenterology, University Medical Center Ho Chi Minh City, 215 Hong Bang, Cho Lon Ward, Ho Chi Minh City 71724, Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thao Thu","family":"Ngan","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Nguyen Tat Thanh University, Ho Chi Minh City 71724, Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thuy Thi Thanh","family":"Trinh","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, University Medical Center Ho Chi Minh City, 215 Hong Bang, Cho Lon Ward, Ho Chi Minh City 71724, Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,8,14]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"420","DOI":"10.1053\/j.gastro.2017.04.022","article-title":"Global prevalence of Helicobacter pylori infection: Systematic review and meta-analysis","volume":"153","author":"Hooi","year":"2017","journal-title":"Gastroenterology"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"e374","DOI":"10.1097\/PG9.0000000000000374","article-title":"Helicobacter pylori Eradication Rate Using Stool Antigen Test in Vietnamese Children: A Prospective Multicenter Study","volume":"4","author":"Nguyen","year":"2023","journal-title":"JPGN Rep."},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Dao, L.V., Dao, H.V., Nguyen, H.T., Vu, V.T., Tran, A.T.N., Dat, V.Q., Hoang, L.B., Nguyen, H.T.V., and Nguyen, T.D. 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Hepatol."}],"container-title":["Antibiotics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2079-6382\/14\/8\/826\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T18:27:11Z","timestamp":1760034431000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2079-6382\/14\/8\/826"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,14]]},"references-count":15,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2025,8]]}},"alternative-id":["antibiotics14080826"],"URL":"https:\/\/doi.org\/10.3390\/antibiotics14080826","relation":{},"ISSN":["2079-6382"],"issn-type":[{"value":"2079-6382","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8,14]]}}}