COMPARISON OF TWO COMMONLY USED SEQUENTIAL THERAPY REGIMENS FOR ERADICATION OF HELICOBACTER PYLORI INFECTION

Aim: To compare the efficacy of levofloxacin based and clarithromycin based sequential therapies for eradication of Helicobacter pylori infection. Methods: From january 2017 to december 2018, 260 patients with H. pylori infection randomly received 14 d of levofloxacin-based sequential therapy (LEVO-ST group, n = 130) or clarithromycin-based sequential therapy (CLA-ST group, n = 130).H.pylori infection was defined on the basis of either histologic evidence of H. pylori by modified Giemsa staining: or a positive rapid urease test by gastric mucosal biopsy. Successful eradication therapy for H.pylori infection was defined as a negative 13-Carbon ?urea breath test four weeks after the end of eradication treatment.Compliance was defined as good when drug intake was at least 90%. H. Pylori eradication rates, patient compliance with drug treatment, adverse events, and factors influencing the efficacy of eradicationtherapy were evaluated. Results: The eradication rates by intention-to-treatanalysis were 89% (116/130: 95%ci: 86.2%-95.4%)in the levo-st group and 86% (112/130: 95%ci:65.8%-77.4%) in the cla-st group (p = 0.450). Theeradication rates by per-protocol analysis were 91%(114/124) 95%ci: 89.1%-98.1%) in the LEVO-ST groupand 87% (106/122: 95%ci: 69.4%-81.8%) in the CLA-ST group (p = 0.227). Compliance was 100% in bothgroups. The adverse event rates were 17.6 % (22/125) and 28.6% (35/122) in the LEVO-ST and CLA-ST group,respectively (p = 0.038). Most of the adverse eventswere mild-to-moderate in intensity: there was none serious enough to cause discontinuation of treatmentin either group. Conclusion: The 14-d levofloxacin-based sequential therapy has high efficacy for H. pylori eradication effective. Moreover, it showed excellent patient compliance and safety compared to the 14-d clarithromycin-based sequential therapy.