title: Levofloxacin-amoxicillin/clavulanate-rabeprazole versus a standard seven-day triple therapy for eradication of Helicobacter pylori infection.
abstract: The resistance rates of Helicobacter pylori to amoxicillin and metronidazole therapy are higher in eastern Taiwan as compared to national and worldwide rates. The high resistance rate in this territory justified a search for a better eradication regimen. We conducted an open-labeled, prospective, randomized, and controlled study in a tertiary referral hospital in eastern Taiwan. Between December 2007 and December 2009, a total of 153 Helicobacter pylori-positive, therapy-naïve patients with a positive rapid urease test were recruited for random assignment to two seven-day treatment groups: levofloxacin (500 mg), amoxicillin/clavulanate (875 mg/125 mg), and rabeprazole (20 mg) twice per day (LAcR) or clarithyromicin (500 mg), amoxicillin (1000 mg), and rabeprazole (20 mg) twice per day (CAR). Helicobacter pylori eradication was assessed using the (13)C-urea breath test or rapid urease test performed at least 4 weeks after the end of treatment. After exclusion, 146 patients were enrolled and allocated in the study. The Helicobacter pylori eradication rates analyzed by both intention to treat (78.1% versus 57.5%, P = 0.008) and perprotocol (80.9% versus 61.8%, P = 0.014) were significantly higher for the LAcR group. In conclusion, the seven-day LAcR regimen provided improved Helicobacter pylori eradication efficacy when compared with the standard CAR triple therapy in eastern Taiwan.
authors.affiliation: Division of Hepatology and Gastroenterology, Department of Internal Medicine, Lotung Poh-Ai Hospital, Lo-Hsu Foundation, No. 83, Nanchang Street, Luodong, Yilan 265, Taiwan.
authors.forename: Ming-Cheh
authors.initials: MC
authors.lastname: Chen
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, Hualien Tzu-Chi Hospital, Buddhist Tzu-Chi Medical Foundation, No. 707, Section 3, ChungYang Road, Hualien 970, Taiwan ; Research Center of Hepatology, Hualien Tzu-Chi Hospital, Buddhist Tzu-Chi Medical Foundation, No. 707, Section 3, ChungYang Road, Hualien 970, Taiwan.
authors.forename: Wei-Yi
authors.initials: WY
authors.lastname: Lei
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, Hualien Tzu-Chi Hospital, Buddhist Tzu-Chi Medical Foundation, No. 707, Section 3, ChungYang Road, Hualien 970, Taiwan.
authors.forename: Jen-Shung
authors.initials: JS
authors.lastname: Lin
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, Hualien Tzu-Chi Hospital, Buddhist Tzu-Chi Medical Foundation, No. 707, Section 3, ChungYang Road, Hualien 970, Taiwan ; Department of Internal Medicine, School of Medicine, College of Medicine, Tzu-Chi University, No. 701, Section 3, ChungYang Road, Hualien 970, Taiwan.
authors.forename: Chih-Hsun
authors.initials: CH
authors.lastname: Yi
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, Kaohsiung Medical University Hospital, No. 100, TzYou 1st Road, Kaohsiung 807, Taiwan ; Department of Internal Medicine, School of Medicine, College of Medicine, Kaohsiung Medical University, No. 100, Shih-Chuan 1st Road, Kaohsiung 807, Taiwan.
authors.forename: Deng-Chyang
authors.initials: DC
authors.lastname: Wu
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, Hualien Tzu-Chi Hospital, Buddhist Tzu-Chi Medical Foundation, No. 707, Section 3, ChungYang Road, Hualien 970, Taiwan ; Research Center of Hepatology, Hualien Tzu-Chi Hospital, Buddhist Tzu-Chi Medical Foundation, No. 707, Section 3, ChungYang Road, Hualien 970, Taiwan ; Department of Internal Medicine, School of Medicine, College of Medicine, Tzu-Chi University, No. 701, Section 3, ChungYang Road, Hualien 970, Taiwan.
authors.forename: Chi-Tan
authors.initials: CT
authors.lastname: Hu
mesh_terms: D000658:Amoxicillin / Q000008:administration & dosage; D019818:Clavulanic Acid / Q000008:administration & dosage; D004338:Drug Combinations; D024881:Drug Resistance, Bacterial / Q000187:drug effects / Q000235:genetics*; D005260:Female; D016481:Helicobacter Infections / Q000188:drug therapy* / Q000235:genetics / Q000473:pathology; D016480:Helicobacter pylori / Q000187:drug effects* / Q000235:genetics / Q000472:pathogenicity; D006801:Humans; D064704:Levofloxacin / Q000008:administration & dosage; D008297:Male; D064750:Rabeprazole / Q000008:administration & dosage
chemical_list: D004338:Drug Combinations; D019818:Clavulanic Acid; D064750:Rabeprazole; D064704:Levofloxacin; D000658:Amoxicillin