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CC BY-NC-ND 4.0 · Journal of Gastrointestinal Infections
DOI: 10.1055/s-0044-1787872
Original Article

Outcome of 14-Day Sequential and Levofloxacin-Based Triple Regimen as the First-Line Therapy in Patients with Helicobacter pylori Infection: A Prospective Comparative Study from Southern Central Nepal

Mukesh Kumar Ranjan 
1   Department of Gastroenterology and Hepatology, Chitwan Medical College and Teaching Hospital, Chitwan, Nepal
,
Pradeep Neupane
1   Department of Gastroenterology and Hepatology, Chitwan Medical College and Teaching Hospital, Chitwan, Nepal
,
Bigyan Maharjan
1   Department of Gastroenterology and Hepatology, Chitwan Medical College and Teaching Hospital, Chitwan, Nepal
,
Sabir Kumar Shrestha
1   Department of Gastroenterology and Hepatology, Chitwan Medical College and Teaching Hospital, Chitwan, Nepal
,
Roshan Kumar Yadav
1   Department of Gastroenterology and Hepatology, Chitwan Medical College and Teaching Hospital, Chitwan, Nepal
,
Asha Sharma
1   Department of Gastroenterology and Hepatology, Chitwan Medical College and Teaching Hospital, Chitwan, Nepal
,
Sandesh Raman Parajuli
2   Department of Internal Medicine, Reading Hospital, Reading, Pennsylvania, United States
,
Sagun Shrestha
1   Department of Gastroenterology and Hepatology, Chitwan Medical College and Teaching Hospital, Chitwan, Nepal
,
Samim Karki
1   Department of Gastroenterology and Hepatology, Chitwan Medical College and Teaching Hospital, Chitwan, Nepal
,
Sabita Gahatraj
1   Department of Gastroenterology and Hepatology, Chitwan Medical College and Teaching Hospital, Chitwan, Nepal
› Author Affiliations Funding None.
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Abstract

Background Helicobacter pylori eradication rates of the commonly used regimens vary among countries and even among different regions of the same country. We aimed to compare the eradication rate and safety of sequential therapy with levofloxacin-based triple therapy.

Methods A comparative single-center study was conducted between October 2022 and November 2023 after obtaining ethical approval. Patients in group A received 14 days of levofloxacin-based triple therapy and those in group B received 14 days of sequential therapy. The eradication of H. pylori was assessed 4 weeks after the completion of the assigned regimens. The data regarding adverse events were also recorded.

Results Among 150 patients (group A: 70, group B: 80) with mean age of 41.7 ± 15.0 years, 67 (44.6%) were male. The eradication was achieved in 65 (92.9%) in group A and 63 (78.8%) in group B, respectively (p = 0.01). All the patients in group A and 76 (95%) patients in group B had good compliance with medication. Adverse events were noticed in 7 (10%) in group A compared to 31 (38.7%) in group B (p < 0.001). The most common adverse events in group A and group B were drug-related diarrhea (3 [4.3%] vs. 11 [13.7%]), gastrointestinal intolerance (2 [2.8%] vs. 6 [7.5%]), and bad/metallic taste (1 [1.4%] vs. 22 [27.5%]). No serious adverse events were noted in both groups.

Conclusion Sequential therapy is significantly less effective and has more nonserious adverse events compared to levofloxacin-based triple therapy in eradication of H. pylori.

Keywords

Helicobacter pylori - sequential therapy - levofloxacin-based triple therapy - eradication - adverse events - first line therapy

Ethical Approval

Ethical approval was obtained by the institute's review committee with approval number CMC-IRC/079/080062.


Consent to Participate

All the patients provided written informed consent.


Authors' Contributions

M.K.R.: Conceptualization of the study, data collection and supervision, data analysis, writing the manuscript, revision and editing of the manuscript. P.N.: Data collection, review of literature, data analysis, writing the manuscript. B.M.: Data collection, review of literature, data analysis, writing the manuscript. S.K.S.: Data collection, review of literature, data analysis, writing the manuscript. R.K.Y.: Data collection, review of literature, data analysis, writing the manuscript. A.S.: Data collection, review of literature, data analysis, writing the manuscript. S.R.P.: Review of literature, data analysis, manuscript writing and revision of the manuscript. S.S.: Data collection, data analysis, review of literature, writing the manuscript. S.K.: Data collection, data analysis, review of literature, writing the manuscript. S.G.: Data collection, data analysis, review of literature, writing the manuscript.


Data Availability Statement

The data can be obtained from the corresponding author on a reasonable request.


Supplementary Material



Publication History

Received: 04 May 2024

Accepted: 24 May 2024

Article published online:
26 July 2024

© 2024. Gastroinstestinal Infection Society of India. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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