The application of bismuth quadruple therapy containing minocycline and levofloxacin in patients with Helicobacter pylori infection

Zhang Yuexia; Zhang Lingyun; Lan Yu; Si Xiaobei

doi:10.3760/j.issn.1673-4777.2025.07.011

Abstract：Objective To investigate the eradication rate and safety of bismuth-based quadruple therapy containing minocycline and levofloxacin in newly diagnosed patients with Helicobacter pylori(Hp)infection.Methods A total of 280 patients with Hp infection who were initially treated in Beijing Jishuitan Hospital,Capital Medical University from January 2022 to October 2023 were enrolled.According to the random number table method,they were divided into minocycline and levofloxacin group(observation group)and amoxicillin and clarithromycin group(control group),with 140 cases in each group.Both groups were combined with rabeprazole and bismuth potassium citrate to form a quadruple regimen for 14 days.The medication safety and compliance of patients were followed up for 3 to 5 days after the end of medication.Hp eradication rate was determined by 13C urea breath test after 4 to 12 weeks.Results Intention-to-treat(ITT)analysis(One case was excluded in the study due to refusal to take medication,afterwards 139 cases in the observation group and 140 cases in the control group)and protocol-following(PP)analysis(after removing the subsequently excluded patients,both the observation group and the control group had 134 cases)showed that the eradication rates of the observation group were higher than those of the control group[ITT analysis:92.1％(128/139)vs 80.7％(113/140),x2=7.667,P=0.006;PP analysis:95.5％(128/134)vs 84.3％(113/134),x2=9.267,P=0.002].Age,sex,body mass index,endoscopic findings and smoking had no significant effect on the eradication rate(all P＞0.05).The proportion of abnormal taste in the observation group was lower than that in the control group(P＜0.05).There was no significant difference in other adverse reactions between the two groups(all P＞0.05).Conclusion The bismuth-based quadruple therapy containing minocycline and levofloxacin has an ideal eradication rate,safety and compliance in Hp naive patients.