Levofloxacin-Amoxicillin/Clavulanate-Rabeprazole versus a Standard Seven-Day Triple Therapy for Eradication ofHelicobacter pyloriInfection

Abstract

The resistance rates ofHelicobacter pylorito 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 153Helicobacter 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 pylorieradication was assessed using the13C-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. TheHelicobacter pylorieradication 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 improvedHelicobacter pylorieradication efficacy when compared with the standard CAR triple therapy in eastern Taiwan.