Levofloxacin based regimens for the eradication of Helicobacter pylori

Eur J Gastroenterol Hepatol. 2002 Dec;14(12):1309-12. doi: 10.1097/00042737-200212000-00004.

Abstract

Background: A 7 day treatment scheme based on rabeprazole/levofloxacin/amoxycillin or tinidazole achieved an eradication rate over 90%. However, the combination of drugs and duration of treatment for the correct use of levofloxacin in the eradication of are still unclear.

Objective: To compare the efficacy and tolerability of rabeprazole/levofloxacin based dual therapies given for 5, 7 or 10 days with rabeprazole/levofloxacin/amoxycillin triple therapy for 7 days.

Methods: One hundred and sixty patients with infection documented by the C-urea breath test and histology were included in this prospective, open label study. Subjects were randomized in four groups: (1) levofloxacin (500 mg o.d.), amoxycillin (1 g b.d.) and rabeprazole (20 mg o.d.) for 7 days; (2) levofloxacin (500 mg o.d.) and rabeprazole (20 mg o.d.) for 5 days; (3) levofloxacin (500 mg o.d.) and rabeprazole (20 mg o.d.) for 7 days; and (4) levofloxacin (500 mg o.d.) and rabeprazole (20 mg o.d.) for 10 days. Six weeks after the end of therapy status was checked by using the C-urea breath test.

Results: All patients completed the therapeutic regimens. The eradication rate was not significantly modified by treatment duration in the dual therapy schemes (5 days: 20/40, 50%; 7 days: 28/40, 70%; 10 days: 26/40, 65%). The eradication rate of the 1 week levofloxacin based triple therapy was significantly higher than that observed using any dual therapies (36/40). No major adverse effects were observed.

Conclusions: A rabeprazole/levofloxacin dual eradication regimen is simple and well tolerated but does not achieve an acceptable eradication rate when compared to a 1 week rabeprazole/levofloxacin/amoxycillin triple therapy. The eradication rate did not increase with a longer regimen.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Anti-Infective Agents / therapeutic use*
  • Female
  • Helicobacter Infections / drug therapy*
  • Helicobacter pylori*
  • Humans
  • Levofloxacin*
  • Male
  • Middle Aged
  • Ofloxacin / therapeutic use*
  • Patient Compliance
  • Prospective Studies
  • Treatment Outcome

Substances

  • Anti-Infective Agents
  • Levofloxacin
  • Ofloxacin