Comparison of Standard Triple Therapy Regimen with Sequential Therapy Regimen Containing Levofloxacin Used for the Eradication of Helicobacter Pylori in Patients with Gastrointestinal Infection Caused by Helicobacter Pylori

Abstract

Objectives: The aim of this study was to compare standard triple therapy regimen with sequential therapy regimen containing levofloxacin used for the eradication of H. pylori in patients with gastrointestinal infection caused by H. pylori. Methods: This single blind clinical trial study was conducted on 96 patients with positive Rapid Urease Test (RUT) who were referred to the Endoscopy center of Hajar Hospital in Shahrekord city, located in southwest of Iran. The patients were randomly assigned into two treatment groups: sequential therapy regimen and triple therapy regimen. The patients in the first group received sequential therapy regimen including omeprazole, amoxicillin, levofloxacin, and tinidazole; the second group of patients received a triple therapy regimen consisting of omeprazole, amoxicillin, and clarithromycin. Four weeks after the end of the treatment, using H. pylori Stool Antigen (HpSA), a test was performed to prove the eradication of H. pylori. The influences of patients’ age, gender and eradication level were also investigated. Results: There were significant differences between the two groups in terms of age and education. While H. pylori eradication rate was 67.3% in the sequential therapy regimen, it was 66% in standard triple therapy regimen. In addition, among patients receiving triple therapy regimen, being aged older than 40 years had a significant relationship with eradication. Moreover, in patients receiving sequential therapy regimen, education level had a significant relationship with eradication. Conclusion: There was no statistically significant difference between the two therapy groups in terms of H. pylori eradication rate. However, given the low rates of H. pylori eradication in both sequential and triple therapy regimens observed in the present study, it seems that it is necessary to conduct further research on the bacterial resistance to the prescribed antibiotics