Second-lineHelicobacter pylori(H. pylori) eradication with fluoroquinolone-containing triple therapy is one of the recommended treatment options, but neither 7-day nor 10-day regimens provide >90% success rates. The current retrospective study aimed to clarify the effects of 10-day and 14-day levofloxacin-containing triple therapies for second-lineH. pylorieradication in a Taiwanese cohort and to evaluate the potential clinical factors influencing eradication. A total of 200 patients who failedH. pylorieradication using the standard triple therapy were prescribed with either a 10-day (EAL-10) or a 14-day (EAL-14) levofloxacin-containing triple therapy group (levofloxacin 500 mg once daily, amoxicillin 1 g twice daily, and esomeprazole 40 mg twice daily). Follow-up studies to assess treatment response were carried out 8 weeks later. Eradication rates attained by EAL-10 and EAL-14 were 75.6%; 95%CI=63.9–85.3% and 92.5%; 95%CI=84.5–98.1%,P=0.002in the per protocol analysis and 68%; 95%CI=56.6–78.5% and 86%; 95%CI=76.8–93.4%,P=0.002in the intention-to-treat analysis. The duration ofH. pyloritherapy is the independent risk factor ofH. pylorieradication (P=0.003). In conclusion, 14-day levofloxacin-containing triple therapy can provide a >90%H. pylorieradication rate, but 10-day treatment duration may be suboptimal. The longer duration ofH. pyloritherapy (14 days) is the independent risk factor.
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