LEVOFLOXACIN VERSUS CLARITHROMYCIN FOR HELICOBACTER PYLORI ERADICATION: ARE 14-DAY REGIMENS BETTER THAN 07-DAY REGIMENS.

Abstract

Background: The effectiveness of the conventional clarithromycin therapy for eradicating Helicobacter pylori has significantly decreased in recent years, likely because of antimicrobial resistance. Therefore, the levofloxacin-based regimen has been utilized as a last-resort treatment option. However, more data should be available regarding its effectiveness in eliminating the issue. This study sought to compare the eradication rate of a levofloxacin-based regimen with that of the conventional first-line clarithromycin regimen.

Study Design: A cross-sectional study.

Place and Duration of the Study: Department of Medicine, MTI, LRH Peshawar, Pakistan from 05 April 2022 to 05 june 2022.

Methods: Individuals who had either a clarithromycin-based regimen or levofloxacin triple treatment for seven or fourteen days after being diagnosed with H. pylori infection were included. If a patient took a proton pump inhibitor or antibiotic within two weeks or four weeks after the H. pylori eradication confirmation test, they were eliminated from the study. Evaluations were conducted on the rate of H. pylori eradication, the effects of diabetes, and the results of esophagogastroduodenoscopy (EGD).

Results: Of the 125 patients, 50 were assigned to the clarithromycin group and 75 to the levofloxacin group. 55.4% were male and 45.6% were female. The average age of the patients was 27.02±11.16. Most patients in both groups had treatment for 14 days instead of 07 days (P = 0.003). Therapy with levofloxacin was linked to a more significant percentage of eradication than therapy with clarithromycin (76.2 vs. 61%, respectively; P = 0.03). The most excellent eradication rate was achieved with a 14-day levofloxacin-based treatment followed by a 14-day clarithromycin regimen (82.4 vs. 68.4%; P = 0.04). The eradication rates for the ten-day regimens were 64.6 and 42.4%, respectively (P = 0.10). Diabetes or EGD results did not affect H. pylori eradication (P = 0.84 and 0.2, respectively).

Conclusions: The study demonstrates the effectiveness of the levofloxacin-based regimen in eliminating Helicobacter pylori infection than the traditional clarithromycin regimen, particularly when given for 14 days. The patients on a 14-day clarithromycin regimen and those on a 14-day levofloxacin therapy had the most excellent eradication rates, respectively. These results highlight the need to consider other treatment options, significantly when antibiotic resistance is rising. More investigation is necessary to determine the efficacy and possible side effects of extended levofloxacin medication, which will help doctors tailor H. pylori eradication treatments.