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

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

Vahid Sebghatollahi et al. Adv Biomed Res.

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.

Keywords: Clarithromycin; Helicobacter pylori; levofloxacin; tinidazole.

Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Flow diagram of patient's recruitment
Figure 2
Figure 2
Overall Helicobacter pylori eradication in studied population by age group

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