Levofloxacin-Amoxicillin/Clavulanate-Rabeprazole versus a Standard Seven-Day Triple Therapy for Eradication of Helicobacter pylori Infection

• Published in: BioMed research international Vol. 2014; no. 2014; pp. 1 - 7
• Main Authors: Lin, Jen-Shung, Chen, Ming-Cheh, Hu, Chi-Tan, Wu, Deng-Chyang, Yi, Chih-Hsun, Lei, Wei-Yi
• Format: Journal Article
• Language: English
• Published: Cairo, Egypt Hindawi Puplishing Corporation 01.01.2014; Hindawi Publishing Corporation; John Wiley & Sons, Inc; Hindawi Limited
• Subjects: Amoxicillin - administration & dosage; Antibiotics; Biomedical research; Buddhism; Clavulanic Acid - administration & dosage; Clinical Study; Clinical trials; Colleges & universities; Comparative analysis; Compliance; Drug Combinations; Drug dosages; Drug Resistance, Bacterial - drug effects; Drug Resistance, Bacterial - genetics; Drug therapy; Drug therapy, Combination; Female; Gastroenterology; Helicobacter infections; Helicobacter Infections - drug therapy; Helicobacter Infections - genetics; Helicobacter Infections - pathology; Helicobacter pylori; Helicobacter pylori - drug effects; Helicobacter pylori - genetics; Helicobacter pylori - pathogenicity; Hepatology; Humans; Infections; Internal medicine; Levofloxacin - administration & dosage; Male; Medicine; Rabeprazole - administration & dosage; Rural areas; Ulcers
• ISSN: 2314-6133; 2314-6141
• DOI: 10.1155/2014/158520

The resistance rates of Helicobacter pylori to amoxicillin and metronidazole therapy are higher in eastern Taiwan as compared to national and worldwide rates. The high resistance rate in this territory justified a search for a better eradication regimen. We conducted an open-labeled, prospective, randomized, and controlled study in a tertiary referral hospital in eastern Taiwan. Between December 2007 and December 2009, a total of 153 Helicobacter pylori-positive, therapy-naïve patients with a positive rapid urease test were recruited for random assignment to two seven-day treatment groups: levofloxacin (500 mg), amoxicillin/clavulanate (875 mg/125 mg), and rabeprazole (20 mg) twice per day (LAcR) or clarithyromicin (500 mg), amoxicillin (1000 mg), and rabeprazole (20 mg) twice per day (CAR). Helicobacter pylori eradication was assessed using the 13C-urea breath test or rapid urease test performed at least 4 weeks after the end of treatment. After exclusion, 146 patients were enrolled and allocated in the study. The Helicobacter pylori eradication rates analyzed by both intention to treat (78.1% versus 57.5%, P=0.008) and perprotocol (80.9% versus 61.8%, P=0.014) were significantly higher for the LAcR group. In conclusion, the seven-day LAcR regimen provided improved Helicobacter pylori eradication efficacy when compared with the standard CAR triple therapy in eastern Taiwan.