Brief Article
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World J Gastrointest Pharmacol Ther. May 6, 2013; 4(2): 23-27
Published online May 6, 2013. doi: 10.4292/wjgpt.v4.i2.23
Standard triple versus levofloxacin based regimen for eradication of Helicobacter pylori
Raj Gopal, Thirthar Palanivelu Elamurugan, Vikram Kate, Sadasivan Jagdish, Debdatta Basu
Raj Gopal, Thirthar Palanivelu Elamurugan, Vikram Kate, Sadasivan Jagdish, Debdatta Basu, Department of Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry 605006, India
Debdatta Basu, Department of Pathology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry 605006, India
Author contributions: Gopal R and Elamurugan TP performed data extraction, analysis and interpretation; Kate V, Jagdish S and Basu D designed the research, corrected and approved the manuscript; all authors read and approved the final manuscript.
Correspondence to: Vikram Kate, MS, PhD, FRCS, MAMS, FIMS, FACS, FACG, Professor, Department of Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research, Dhanvantri Nagar, Puducherry 605006, India. drvikramkate@gmail.com
Telephone: +91-413-2296000 Fax: +91-413-2296000
Received: December 8, 2012
Revised: January 13, 2013
Accepted: January 23, 2013
Published online: May 6, 2013
Processing time: 149 Days and 8.3 Hours
Abstract

AIM: To compare the eradication rates for Helicobacter pylori (H. pylori) and ulcer recurrence of standard triple therapy (STT) and levofloxacin based therapy (LBT).

METHODS: Seventy-four patients with perforated duodenal ulcer treated with simple closure and found to be H. pylori infected on 3 mo follow up were randomized to receive either the STT group comprising of amoxicillin 1 g bid, clarithromycin 500 mg bid and omeprazole 20 mg bid or the LBT group comprising of amoxicillin 1 g bid, levofloxacin 500 mg bid and omeprazole 20 mg bid for 10 d each. The H. pylori eradication rates, side effects, compliance and the recurrence of ulcer were assessed in the two groups at 3 mo follow up.

RESULTS: Thirty-four patients in the STT group and 32 patients in the levofloxacin group presented at 3 mo follow up. H. pylori eradication rates were similar with STT and the LBT groups on intention-to-treat (ITT) analysis (69% vs 80%, P = 0.425) and (79% vs 87%, P = 0.513) by per-protocol (PP) analysis respectively. Ulcer recurrence in the STT and LBT groups on ITT analysis was (20% vs 14%, P = 0.551) and (9% vs 6%, P = 1.00) by PP analysis. Compliance and side effects were also comparable between the groups. A complete course of STT costs Indian Rupees (INR) 1060.00, while LBT costs only INR 360.00.

CONCLUSION: H. pylori eradication rates and the rate of ulcer recurrence were similar between the STT and LBT. The LBT is a more economical option compared to STT.

Keywords: Helicobacter pylori; Eradication; Peptic perforation; Levofloxacin regime; Randomized control trial; Standard triple therapy