Comparison of the once-daily levofloxacin-containing triple therapy with the twice-daily standard triple therapy for first-line Helicobacter pylori eradication: a prospective randomised study.

Summary Background/Aims:  Simple compound of Helicobacter pylori eradication therapy may improve drug compliance of patients. The aims of this study were to compare the efficacy and tolerability of a simple combination containing levofloxacin 7-day once-daily with standard twice-daily triple therapy. Patients and Methods:  This was a prospective, randomised, open-label trial. A total of 189 consecutive patients diagnosed with peptic ulcer and H. pylori infection were enrolled. Patients were randomly divided into two groups: LEC group – levofloxacin 500 mg, esomeprazole 40 mg and clarithromycin 500 mg once daily for 7 days; AEC group – amoxicillin 1 g, esomeprazole 40mg and clarithromycin 500 mg twice daily for 7 days. Results:  There were 90 patients in the LEC group and 99 patients in the AEC group. By intention-to-treat and per-protocol analysis, the H. pylori eradication rate was 78.9% [71/90; 95% confidence interval (CI), 70.3–87.5%] and 83.5% (71/85; 95% CI, 75.5–91.6%) respectively, in the LEC group; and 74.8% (74/99; 95% CI, 66.0–83.5%) and 86.0% (74/86; 95% CI, 78.6–93.5%) respectively, in the AEC group. The incidence and tolerability of side effects were similar between these two groups. Conclusion:  The efficacy and tolerability of once-daily levofloxacin-containing triple therapy are equal to those of the standard twice-daily triple therapy in this study. However, none of the treatment regimens evaluated achieved enough eradication efficacies to be considered as a recommendable first-line treatment.