Clinical Study of Doxycycline-based Quadruple Regimen as a Rescue Therapy after Failure of Initial Eradication Therapy of Helicobacter pylori

Background: The failure rate of first-line triple therapy for Helicobacter pylori(H.pylori) is increasing in recent years.Aims: To assess the efficacy and safety of doxycycline-based quadruple regimen as a rescue therapy after failure of initial eradication therapy of H.pylori.Methods: Thirty-seven patients with peptic ulcer,chronic atrophic gastritis or non-ulcer dyspepsia,who had a failed course of initial eradication therapy,were given the following quadruple therapy: esomeprazole(20 mg)+bismuth potassium citrate(220 mg)+doxycycline(100 mg)+amoxicillin(1000 mg),twice daily for 10 days.The status of H.pylori was assessed by 13C-urea breath test(UBT) 4 weeks after therapy.Results: Four patients dropped out in the follow-up study,25 patients had their H.pylori successfully eradicated,and 8 patients remained H.pylori positive.The H.pylori eradication rates of rescue therapy by intention-to-treat(ITT) and per-protocol(PP) analysis were 67.6% and 75.8%,respectively.Slight or mild side effects occurred in 21(63.6%) patients.Conclusions: Doxycycline-based quadruple regimen is a safe and effective rescue therapy after a failed initial eradication therapy.