Intravenous metronidazole‐, levofloxacin‐containing triple therapy for treating patients with Helicobacter pylori‐related active peptic ulcer complications: A pilot study

Abstract

AbstractObjectiveThe aim of this pilot study was to evaluate the efficacy and safety of intravenous use esomeprazole, metronidazole, and/or levofloxacin in the treatment of Helicobacter pylori (H. pylori)‐associated peptic ulcer complications.MethodsInpatients with peptic ulcer complications who were not able to take oral medicine were randomly assigned to three groups: triple therapy (esomeprazole, levofloxacin, metronidazole) and dual therapy (esomeprazole, levofloxacin/metronidazole) for 7 days. After intravenous treatment, all patients received open‐label oral esomeprazole 20 mg bid for another 1 month. All subjects were followed up for gastroscopy at the seventh day of intravenous treatment to confirm the ulcer healing and 13C‐urea breath test to confirm successful H. pylori eradication 4–6 weeks after completion of oral esomeprazole therapy.ResultsThe H. pylori eradication rate of both LEV‐dual therapy (33.3%, 95% CI: 9.7%–70.0%) and MTZ‐dual therapy (50%, 95% CI: 21.5%–78.5%) was significantly lower than that of triple therapy (95%, 95% CI: 71.1%–97.4%) (p = .003, .016). There were no significant differences in the adverse effects among all treatment groups, and the adverse effects were rare.ConclusionsThe intravenous triple regimen, consisting of proton‐pump inhibitor, metronidazole, and levofloxacin, could be considered in patients of H. pylori‐associated peptic ulcer complications if oral medicine cannot be provided.