A Comparison of the Effectiveness of Levofloxacin versus Clarithromycin as first line therapy in the eradication of Helicobacter pylori infection: A randomized clinical trial

9/23/2020 12:37:54 PM


Helicobacter pylori (H. pylori) is the main known cause of gastritis, gastroduodenal ulcer disease, and gastric cancer. Eradication of H. pylori can be an effective method of treatment for peptic ulcer disease and mucosa‐associated lymphoid tissue lymphoma. It is especially important for reducing the development of new‐onset gastric cancer as well as secondary gastric cancer after endoscopic treatment. This study aimed to compare the effectiveness of Levofloxacin versus Clarithromycin in the eradication of H. pylori.


This randomized clinical trial study was conducted on 170 cases with H. pylori infection in Afzalipour Hospital, Kerman, Iran. They randomly allocated to two groups. ‘A’ group was treated with Clarithromycin (500 mg twice a day), Pantoprazole (40 mg twice a day) and Amoxicillin (1 gr twice a day) for 14 days. ‘B’ group was treated with Levofloxacin (250 mg twice a day), Pantoprazole (40 mg twice a day) and Amoxicillin (1 gr twice a day) for 14 days for first line therapy in both groups. Stool H. pylori antigen test was performed on them after one month of the end of treatment. To analyze the data, descriptive and analytical methods and SPSS software version 22 were used.


The study cases are comprised of 170 individuals (52.35% female). The average age of cases in ‘A’ and ‘B’ groups was 42±11.88 and 41±13.75 years, respectively. H. pylori eradication was successful in 61.1% of ‘A’ group and 92.9% of ‘B’ group showing a significant difference (P=0.037). Drug complications were reported in 7.1% of ‘A’ group and 4.7% of ‘B’ group which have not shown a significant difference between the two groups (P=0.771). The most common drug complication in both groups was abdominal pain (2.3%).


The results of this study indicated that the Levofloxacin-containing regimen was more effective in eradicating H. pylori than the standard Clarithromycin triple therapy.