Clarithromycin Versus Levofloxacin-Based Triple Regime in Stool Antigen-Positive Helicobacter Pylori Patients: A Quasi-Experimental Study in Islamabad

Abstract

Objective: To compare the eradication rate and adverse effects of clarithromycin versus levofloxacin-based
triple regimen in patients with positive stool antigen test for Helicobacter pylori.
Study Design: Quasi-experimental study.
Place and Duration of Study: This study was conducted at the Medicine Department of Federal Government
Polyclinic Hospital, Islamabad, Pakistan, from 1^st January 2024 to 30^th December 2024.
Methods: A total of 270 patients with positive stool antigen tests for H. pylori were included using nonprobability
convenience sampling. Patients were allocated into two groups with 135 patients each: Group I received clarithromycin, omeprazole, and amoxicillin, whereas Group II received levofloxacin, omeprazole, and amoxicillin. In each group, 70 patients completed the regimen for 14 days, and 65 patients took it for 10 days. A repeat stool antigen test was performed 4 weeks after completion of the regimen. Data was analyzed using the Statistical Package for the Social Sciences (SPSS) version 26.
Results: Helicobacter pylori were eradicated in 117 (86.7%) and 99 (73.3%) patients with levofloxacin- and clarithromycin-based regimens, respectively (P-value=0.006). Significant eradication was achieved in 53 (81.5%) with levofloxacin versus 43 (66.2%) with a clarithromycin-based regimen, with a 10-day regimen. The eradication rates were significantly higher with levofloxacin than with a clarithromycin-based regimen (91.4% versus 80%) with a 14-day regimen. The adverse effects occurred in 61 (22.6%) patients, 36 (13.3%) occurring in Group I, and 25 (9.3%) in Group II (P-value=0.05). The adverse effects occurred in 3% with a 10-day regime and 6.3% with a 14-day regime, with no statistical significance.
Conclusion: The levofloxacin-based triple regimen is highly effective, eradicating Helicobacter pylori in 86.7% of patients, and is relatively safer, with fewer adverse effects. The best eradication rate is achieved with a 14-day levofloxacin regimen followed by a 14-day clarithromycin regimen and then a 10-day levofloxacin regimen.

How to cite this: Mahmood T, Ahmed R, Jan MN, Aslam A, Azeez H, Tanvir T. Clarithromycin Versus Levofloxacin-Based Triple Regime in Stool Antigen-Positive Helicobacter Pylori Patients: A Quasi-Experimental Study in Islamabad. Life and Science. 2026; 7(1): 39-45. doi: http://doi.org/10.37185/LnS.1.1.1057