A Randomized Comparative Study of Levofloxacin Based Triple Therapy with Standard Triple Therapy for Helicobacter pylori Eradication

Helicobacter pylori are associated with peptic ulcer disease, gastritis and malignancy. Eradication of Helicobacter pylori in patient with peptic ulcer greatly reduces the rate of relapse. Hence, it is vital to find the ideal regimen. Primary antibiotic resistance and poor compliance attribute to eradication failure of standard regimens. This study investigated the eradication rate, patient compliance, tolerability and side effects profile of a one week, once daily levofloxacin plus azithromycin triple therapy versus standard twice daily triple therapy. A prospective, randomized, comparative study, enrolling 72 Helicobacter pylori positive patients, with dyspeptic symptoms was done. These patients were randomized either to the esomeprazole 20 mg, levofloxacin 500mg, and azithromycin 500mg, once daily (ELA Group) or esomeprazole 20mg, clarithromycin 500mg and amoxicillin 1 gm twice daily (ECA group) for 1 week. Helicobacter pylori infection was defined by rapid urease test and histology, both at the entry, as well as at the end of the study. Helicobacter pylori eradication rates of ELA and ECA group were similar (67.6% and 77.1% respectively, p=0.337). Both the treatment groups were similar in terms of compliance (p=0.721) and tolerability (p=0.963). No significant differences were noted in the incidence of side effects between the two treatment groups (p=0.253). Once daily, levofloxacin plus azithromycin-based triple therapy may represent a promising alternative to the standard twice daily triple therapy.