Skip to main page content
Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
, 31 (10), 1077-84

Clinical Trial: Clarithromycin vs. Levofloxacin in First-Line Triple and Sequential Regimens for Helicobacter Pylori Eradication

Affiliations
Randomized Controlled Trial

Clinical Trial: Clarithromycin vs. Levofloxacin in First-Line Triple and Sequential Regimens for Helicobacter Pylori Eradication

J Molina-Infante et al. Aliment Pharmacol Ther.

Abstract

Background: Helicobacter pylori eradication rates with standard triple therapy have declined to unacceptable levels.

Aim: To compare clarithromycin and levofloxacin in triple and sequential first-line regimens.

Methods: A total of 460 patients were randomized into four 10-day therapeutic schemes (115 patients per group): (i) standard OCA, omeprazole, clarithromycin and amoxicillin; (ii) triple OLA, omeprazole, levofloxacin and amoxicillin; (iii) sequential OACM, omeprazole plus amoxicillin for 5 days, followed by omeprazole plus clarithromycin plus metronidazole for 5 days; and (iv) modified sequential OALM, using levofloxacin instead of clarithromycin. Eradication was confirmed by 13C-urea breath test. Adverse effects and compliance were assessed by a questionnaire.

Results: Per protocol cure rates were: OCA (66%; 95% CI: 57-74%), OLA (82.6%; 75-89%), OACM (80.8%; 73-88%) and OALM (85.2%; 78-91%). Intention-to-treat cure rates were: OCA (64%; 55-73%), OLA (80.8%; 73-88%), OACM (76.5%; 69-85%) and OALM (82.5%; 75-89%). Eradication rates were lower with OCA than with all the other regimens (P < 0.05). No differences in compliance or adverse effects were demonstrated among treatments.

Conclusions: Levofloxacin-based and sequential therapy are superior to standard triple scheme as first-line regimens in a setting with high clarithromycin resistance. However, all of these therapies still have a 20% failure rate.

Comment in

Similar articles

See all similar articles

Cited by 32 PubMed Central articles

See all "Cited by" articles

Publication types

MeSH terms

LinkOut - more resources

Feedback