COMPARISON OF LEVOFLOXACIN BASED VERSUS CLARITHROMYCIN BASED TRIPLE REGIMEN THERAPY FOR IN THE ERADICATION OF HELICOBACTER PYLORI

Background: Helicobacter pylori is a globally prevalent gastric pathogen implicated in chronic gastritis, peptic ulcer disease, and gastric malignancies. Rising resistance to commonly used antibiotics, particularly clarithromycin, has led to declining eradication success rates with conventional therapies. Levofloxacin, a fluoroquinolone antibiotic, has emerged as a potential alternative in triple therapy regimens. Evaluating the comparative effectiveness of these treatment options in different populations is essential to guide empirical clinical practice and adapt to regional antibiotic resistance patterns. Objective: To compare the success of levofloxacin-based versus clarithromycin-based triple regimen therapy in the eradication of Helicobacter pylori infection. Methods: This randomized controlled trial was conducted at the Department of Gastroenterology, Sheikh Zayed Medical Complex, Lahore, from April 2 to October 2, 2020. A total of 120 patients, aged 16 to 75 years and diagnosed with H. pylori via ^13C urea breath test, were enrolled and randomly allocated into two equal groups. Group A received omeprazole 40 mg, amoxicillin 1 g, and levofloxacin 250 mg twice daily for 14 days. Group B received omeprazole 40 mg, amoxicillin 1 g, and clarithromycin 500 mg twice daily for the same duration. After 28 days of treatment completion, H. pylori status was reassessed using the ^13C urea breath test. Eradication success was defined by a negative result. Results: The mean age of participants was 44.58 ± 15.16 years, with 88 patients (73.3%) being male. Successful eradication was achieved in 49 patients (81.7%) in the levofloxacin group compared to 39 patients (65.0%) in the clarithromycin group. The difference was statistically significant (p = 0.039). Conclusion: Levofloxacin-based triple therapy demonstrated significantly higher eradication rates than clarithromycin-based therapy, supporting its use as a more effective regimen for the treatment of Helicobacter pylori infection in adult populations.