Vo Thong Duy, Ngan Thao Thu, Trinh Thuy Thi Thanh
Department of Internal Medicine, School of Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City 71724, Vietnam.
Department of Gastroenterology, University Medical Center Ho Chi Minh City, 215 Hong Bang, Cho Lon Ward, Ho Chi Minh City 71724, Vietnam.
Antibiotics (Basel). 2025 Aug 14;14(8):826. doi: 10.3390/antibiotics14080826.
() 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. 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. eradication was assessed using 13C-urea breath test and/or rapid urease test 4-12 weeks after treatment. 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: 1.11-7.74; = 0.039). No other factors were significantly associated. 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.
（）感染在越南仍然非常普遍，与慢性胃炎、消化性溃疡和胃癌有关。本研究旨在评估基于左氧氟沙星的铋剂四联疗法（PALB）作为二线治疗的真实世界根除率，评估依从性，并确定与治疗成功相关的因素。我们进行了一项前瞻性队列研究，纳入225例确诊经典铋剂四联疗法失败的患者。所有患者均接受为期14天的PALB方案治疗。治疗后4至12周，采用13C-尿素呼气试验和/或快速尿素酶试验评估根除情况。根除率分别为78.2%（意向性分析）和78.6%（符合方案分析），95%置信区间与80%的基准重叠。依从性较高（91.6%），且与治疗成功显著相关（比值比=2.93；95%置信区间：1.11-7.74；P=0.039）。没有其他因素与之显著相关。虽然PALB仍然是一种有效的二线治疗方法，但其疗效可能正在下降，尽管在统计学上并不低于80%。提高依从性和加强管理至关重要。
