The Efficacy of Levofloxacin-based Triple Therapy for First-line Helicobacter Pylori Eradication

Introduction: Because of the increasing resistance to clarithromycin and metronidazole, new therapeutic alternatives are needed. The purpose of this study was to compare the efficacy of 7-and 10-day triple therapy including omeprazole, levofloxacin and amoxicilline for Helicobacter pylori eradication as a first-line therapy. Methods: One hundred and five patients with peptic ulcer disease and with non-ulcer dyspepsia infected with Helicobacter pylori were included in this study. Patients were randomized to receive either 7-day or 10-day therapy with omeprazole (20 mg b.i.d.), plus levofloxacin (500 mg o.i.d.) and amoxicilline (1000 mg b.i.d.). Eradication was assessed by negative histological analyses, negative H. pylori stool antigen or rapid urease test. Results: In Group 1, the eradication rate was 86, 2%, while in group 2, eradication rate was 93, 6%. There was no difference between groups (p=0.218). Adverse effects were reported in 5, 25% of the patients, including nausea and diarrhea. Conclusions: The levofloxacin-based regimen can be one effective therapy for the first-line anti-H. pylori treatment. However, a levofloxacin-based triple therapy is not generally recommended as first-line therapy at the moment due to concerns about the rising prevalence of quinolone-resistant strains in the first-line and second-line anti-H. pylori therapies.