The standard first-line therapies for Helicobacter pylori eradication are based on clarithromycin and amoxicillin or metronidazole.
Recent studies suggested levofloxacin as an alternative option for both first-and second-line H pylori eradication treatment.
Dr Enrico Nista and colleagues from Italy evaluated efficacy and tolerability of 2 different 7-day standard triple therapies.
The investigative team 7-day levofloxacin-based triple therapy in first-line treatment for H pylori infection.
|Eradication rates in intention to treat was 75% in Group 1|
|American Journal of Gastroenterology|
The team randomized 300 consecutive H pylori positive patients to receive clarithromycin, amoxicillin, and esomeprazole in Group 1.
Clarithromycin, metronidazole, and esomeprazole was given to 100 patients in Group 2.
Group 3 included 100 patients received clarithromycin, levofloxacin, and esomeprazole.
H pylori status was rechecked by 13C urea breath test 6 weeks after the end of therapy.
The researchers found 16 out of 300 patients discontinued treatment because of the occurrence of side effects.
The eradication rates in intention to treat and per protocol analyses were 75% and 79% in Group 1, and 72% and 77% in Group 2.
The researchers found that the eradication rates in intention to treat and per protocol analyses were 87% and 91% in Group 3.
The eradication rate with levofloxacin-based triple therapy was higher than that with standard therapies in either intention to treat and per protocol analysis.
The team observed no difference between standard triple therapies.
The incidence of side effects was similar among groups.
Dr Nista's team concludes, “A 7-day levofloxacin-based triple therapy can achieve higher H pylori eradication rates than standard regimens.”
“These data suggest levofloxacin-based regimens can be the most effective in first-line anti-H pylori therapy, at least in the Italian population.”