What is sequential levofloxacin-containing therapy for the eradication of Helicobacter pylori infection?

Updated: Dec 09, 2020
  • Author: Joseph Adrian L Buensalido, MD; more...
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Sequential therapy, an alternative first-line regimen, is as follows (eradication rates of up to 86.5%): [36, 15, 12, 2]

  1. PPI (esomeprazole 20 mg or 40 mg BID) plus amoxicillin (1 g BID) for 5-7 days, then

  2. PPI (esomeprazole 20 mg or 40 mg BID) plus levofloxacin (250 mg or 500 mg BID) plus a nitroimidazole antibiotic (eg, tinidazole 500 mg BID) for 5-7 days

A randomized trial investigated the role of bismuth in levofloxacin-containing 14-day sequential therapy, and concluded that adding bismuth did not significantly improve eradication rates (85.2% vs. 82.6%).

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