Journal of Isfahan Medical School

Journal of Isfahan Medical School

The Efficacy of Levofloxacin versus Clarithromycin in Primary Quadruple Therapy for the Eradication of Helicobacter Pylori: A Prospective Randomized Controlled Clinical Trial Study

Document Type : Original Article (s)

Authors
Vahid Sebghatollahi 1
Reyhaneh Hosseini 2
Babak Tamizifar 1
Mohammad Minakari 3
Maryam Soheilipour 4
1 Associate Professor, Department of Gastroenterology and Endoscopy, Khorshid Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
2 Resident, Department of Internal Medicine, Alzahra Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
3 Professor, Department of Gastroenterology and Endoscopy, Khorshid Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
4 Assistant Professor, Department of Gastroenterology and Endoscopy, Khorshid Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
10.22122/jims.v38i569.12768
Abstract
Background: Helicobacter pylori (H. pylori) infection is prevalent in the world. Resistance to antibiotics is the main reason for treatment failure. This clinical trial examined the effect of clarithromycin versus levofloxacin as the content of first line of treatment of the patients with peptic ulcer.Methods: In this double-blind randomized controlled clinical trial study with parallel groups, 148 infected patients by H. pylori who had been proven during endoscopic biopsy were randomly divided into two equal groups. One group was treated with the quadruple therapy of clarithromycin 500 mg BID, amoxicillin 1 g BID, bismuth subcitrate 240 mg BID, and pantazole 40 mg BID. The second group was treated with levofloxacin 500 mg QD, amoxicillin 1 g BID, bismuth subcitrate 240 mg BID, and pantazole 40 mg BID. The duration of treatment was 14 days in both groups and four weeks after treatment, the eradication rate was assessed using the stool antigen test.Findings: The eradication rate was significantly higher using regime containing clarithromycin than that of levofloxacin [81.1%; confidence interval of 95% (95%CI): 72.2%-89.9% vs. 60.3%; 95%CI: 49.3%-72.2%; P = 0.021). The improvement in quality of life in patients treated with clarithromycin was comparable with levofloxacin (7.90 ± 5.79 vs. 9.27 ± 5.89; P = 0.18). Adverse effects were different between the groups in which bad taste was reported more frequently in clarithromycin than levofloxacin (27.0% vs. 4.3%) while epigastric pain was more in levofloxacin (7.1% vs. 2.7%).Conclusion: The effectiveness of clarithromycin on H. pylori eradication rate was significantly higher than levofloxacin.
Keywords
Helicobacter pylori
Clarithromycin
Levofloxacin
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Journal of Isfahan Medical School
Volume 38, Issue 569 - Serial Number 569
March and April 2020
Pages 186-192

  • Receive Date 19 February 2020
  • Accept Date 06 April 2022