Abstract
Background: Helicobacter pylori infection is associated with peptic ulcer diseases and gastric adenocarcinoma. Accordingly, the aim of this study was to assess the efficiency of tetracycline quadruple therapy versus levofloxacin-based regimen (LBR) for the eradication of H. pylori. Methods: To this end, 197 subjects with H. pylori infection were recruited in this randomized clinical study in Kurdistan region, Iraq between October 2018 and May 2019 and randomly divided into 2 groups. The LBR group received levofloxacin 500 mg one time per day, amoxicillin 1000 mg two times per day, and omeprazole 20 mg two times per day for two weeks. In addition, the tetracycline-metronidazole-bismuth (TMB) group received bismuth subcitrate 140 mg, metronidazole 125 mg, and tetracycline 125 mg plus omeprazole 20 mg twice per day for 10 days. Finally, 28 days after the completion of the treatment course, the eradication of H. pylori was evaluated by the 14C urease breath test. Results: The total eradication rate of H. pylori infection was 149/197 (75.6%). Although the success eradication rate in the LBR regimen was 70/112 (62.5%), the eradication success rate was 79/85 (92.9%) in the TMB regimen (P = 0.001, odds ratio = 7.9, confidence interval = 3.17-19.7). Finally, gender and age represented on the effect of the eradication rate. Conclusions: In general, the bismuth-based regimen could eradicate a high rate of H. pylori infection. Therefore, this regimen can be used to overcome treatment failure in areas with a high prevalence of antibiotics resistance.
Highlights
Helicobacter pylori infection is associated with peptic ulcer diseases and gastric adenocarcinoma
The bismuth-containing quadruple or levofloxacin-based regimen (LBR) is advised for H. pylori eradication if the clarithromycin resistance rate is more than 20%
The status of infection was proven by performing a slide urease reaction during endoscopy or by the urea breath test (UBT)
Summary
Helicobacter pylori infection is associated with peptic ulcer diseases and gastric adenocarcinoma. Conclusions: In general, the bismuth-based regimen could eradicate a high rate of H. pylori infection This regimen can be used to overcome treatment failure in areas with a high prevalence of antibiotics resistance. Helicobacter pylori is a gram-negative bacterium that infects half of the populations worldwide [1] It can cause gastric and duodenal ulcer and predispose to individuals gastric adenocarcinoma [2]. The recommended course of the treatment includes the combination of amoxicillin plus clarithromycin with a proton pump inhibitor in the majority of international guidelines for the eradication of H. pylori [4, 5]. The bismuth-containing quadruple or levofloxacin-based regimen (LBR) is advised for H. pylori eradication if the clarithromycin resistance rate is more than 20%. No clinical trial study, to the best of our knowledge, has so far investigated the eradication success rates of bismuthcontaining quadruple or LBR in this country
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
