Levofloxacin-containing versus Clarithromycin-containing Therapy for Helicobacter pylori Eradication: A Prospective Randomized Controlled Clinical Trial

Abstract

Background:This study evaluated the clinical efficacy and tolerability of a 14-day course of bismuth-based quadruple therapy including tinidazole and levofloxacin in compare to a 14-day bismuth-based quadruple therapy including clarithromycin as first-line treatment for Helicobacter pylori infection in Iranian adults.Materials and Methods:The study was a prospective, parallel group, randomized controlled, clinical trial that conducted on 150 patients with H. pylori infection. Patients were randomly assigned to the two groups as follows: first group received pantoprazole 40 mg, bismuth subcitrate 240 mg, amoxicillin 1 g, and clarithromycin 500 mg (PBAC group), and other group received pantoprazole 40 mg, bismuth subcitrate 240 mg, amoxicillin 1 g, tinidazole 500 mg for 7 days, followed by levofloxacin 500 mg for the second 7 days (PBATL group). Main outcomes were eradication rate, tolerance of treatment, and dyspepsia severity.Results:The eradication rates for PBAC regimen was 81.1% (95% confidence interval [CI]: 71.9–90.2) and for PBATL regimen was 70.8% (95% CI: 60.1–81.6), which was not significantly different (P = 0.147). Tolerance of treatment was similar between groups. The median of severity of dyspeptic after treatment in PBAC group was 10 [9–14.75], which was similar to PBATL group 10 [9–13.5] (P = 0.690).Conclusion:There is no significant difference between PBAC and PBATL regimen, and efficacy was similar in both groups. The overall rate of treatment failure suggests that up to 18%–30% of patients will fail bismuth-based quadruple therapy and require retreatment for the infection.

The Efficacy, Safety, And Tolerability of Levofloxacin Quadruple Therapy For Helicobacter Pylori Eradication: A Randomized, Double-Blind Clinical Trial

“…However, studies conducted in other parts of Iran revealed uoroquinolone-containing regimens including a 14-day of omeprazole, levo oxacin (250 mg twice a day) and amoxicillin as well as a 14-day of omeprazole, levo oxacin (500 mg twice a day), and amoxicillin as rescue therapies of H. pylori had eradication rate of 90 % and 86.7 %, respectively [43,44]. Moreover, there are some other Iranian investigations that evaluated the e cacy of levo oxacin-based, sequential therapy in the treatment of H. pylori, and the eradication rate ranged from 70.8% to 85.1 % [45][46][47].…”

“…Previous studies have also demonstrated the eradication rate of levo oxacin-containing regimens was not associated with age [45,47,44], gender [46,45,44], smoking status [48,45], and education level [45].…”

The efficacy, safety, and tolerability of levofloxacin quadruple therapy for helicobacter pylori eradication: a randomized, double-blind clinical trial

“…However, studies conducted in other parts of Iran revealed uoroquinolone-containing regimens including a 14-day of omeprazole, levo oxacin (250 mg twice a day) and amoxicillin as well as a 14-day of omeprazole, levo oxacin (500 mg twice a day), and amoxicillin as rescue therapies of H. pylori had eradication rate of 90% and 86.7%, respectively [43,44]. Moreover, there are some other Iranian investigations that evaluated the e cacy of levo oxacin-based, sequential therapy in the treatment of H. pylori, and the eradication rate ranged from 70.8% to 85.1% [45][46][47].…”

“…No relationship was observed between patient demographic characteristics including age, gender, cigarette smoking, and alcohol drinking and the success rate of both BPAL-7 and PBAL-10 regimens. Previous studies have also demonstrated the eradication rate of levo oxacin-containing regimens was not associated with age [45,47,44], gender [46,45,44], smoking status [48,45], and education level [45].…”

Response to “Levofloxacin-containing versus Clarithromycin-containing Therapy for Helicobacter pylori Eradication: A Prospective Randomized Controlled Clinical Trial”

“…I read with a great interest the article titled, “Levofloxacin-containing versus clarithromycin-containing therapy for Helicobacter pylori eradication: A prospective randomized controlled clinical trial”[ 1 ] authored by Sebghatollahi et al . I would like to compliment the authors for conducting a study on a widely prevalent disease with a very good design.…”