Helicobacter pylori eradication by the conventional clarithromycin therapy has largely dropped in the recent years possibly due to antimicrobial resistance. Hence, levofloxacin-based regimen has been used as salvage therapy. However, data regarding its effectiveness on eradication are controversial. This study aimed to compare the eradication rate of levofloxacin-based regiment to that of the conventional first-line clarithromycin regimen. Patients diagnosed with H. pylori infection and treated with levofloxacin triple therapy or clarithromycin-based regimen for 10 or 14 days were included. Patients were excluded if they used antibiotics or proton pump inhibitors within 4 or 2 weeks, respectively, of the H. pylori eradication confirmation test. H. pylori eradication rate was assessed, as well as the impact of diabetes and esophagogastroduodenoscopy (EGD) findings. Of 245 patients, 145 were in the levofloxacin group and 100 in the clarithromycin group. Most patients in either group received therapy for 14 days vs. 10 days (P = 0.002). Levofloxacin-based treatment was associated with a higher eradication rate compared with clarithromycin-based treatment (74.5 vs. 62%, respectively; P = 0.04). The 14 day levofloxacin-based regimen resulted in the highest eradication rate, followed by the 14 day regimen of clarithromycin (80.9 vs. 66.3%; P = 0.03). The 10 day regimens exhibited 62.7 and 41.2% eradication rates, respectively (P = 0.12). H. pylori eradication was not affected by diabetes or EGD findings (P = 0.98 and 0.3, respectively). Results from this study support the use of a levofloxacin-based regimen as a first-line therapy in the treatment of H. pylori infection for 14 days regardless of diabetes and EGD findings.

中文翻译：

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左氧氟沙星与克拉霉素根除幽门螺杆菌：14 天方案是否优于 10 天方案？

近年来，通过常规克拉霉素疗法根除幽门螺杆菌的可能性大大下降，这可能是由于抗菌素耐药性。因此，基于左氧氟沙星的方案已被用作补救治疗。然而，关于其根除效果的数据存在争议。本研究旨在比较以左氧氟沙星为基础的方案与常规一线克拉霉素方案的根除率。被诊断为幽门螺杆菌感染并接受左氧氟沙星三联疗法或克拉霉素治疗 10 天或 14 天的患者被纳入研究。如果患者分别在幽门螺杆菌根除确认试验的 4 周或 2 周内使用抗生素或质子泵抑制剂，则被排除在外。评估了幽门螺杆菌根除率，以及糖尿病和食管胃十二指肠镜检查 (EGD) 结果的影响。245例患者中，左氧氟沙星组145例，克拉霉素组100例。两组中的大多数患者接受了 14 天与 10 天的治疗（P = 0.002）。与基于克拉霉素的治疗相比，基于左氧氟沙星的治疗与更高的根除率相关（分别为 74.5% 和 62%；P = 0.04）。以左氧氟沙星为基础的 14 天方案的根除率最高，其次是 14 天的克拉霉素方案（80.9% vs. 66.3%；P = 0.03）。10 天方案的根除率分别为 62.7% 和 41.2% (P = 0.12)。根除幽门螺杆菌不受糖尿病或 EGD 发现的影响（分别为 P = 0.98 和 0.3）。