Objectives: This study aimed to investigate seven and ten-day courses of levofloxacin-based triple therapy and the effect of levofloxacin concentration in gastric mucosa on Helicobacter pylori (Hp) eradication.
Methods: Levofloxacin (500 mg qd), esomeprazole (20 mg bid) and amoxicillin (1000 mg bid) were used to treat 240 Hp-positive chronic gastritis patients. Patients were randomly divided into seven and ten days treatment groups (n = 120 in each group). The carbon dioxide-14 (14C) breath tests of the patients were reviewed four weeks after the end of the eradication treatment. On the first day after the treatment, four blocks of gastric antrum mucosa were obtained from 61 patients of the seven-day group to determine levofloxacin concentration by using endoscopic biopsy.
Results: A total of 224 patients completed follow-up. Intention-to-treat and per-protocol analyses showed that the Hp eradication rates of the ten-day group were 81.7% and 88.3%, respectively, and the Hp eradication rates of the seven-day group were 78.3% and 83.2%. No statistically significant difference was found between the two groups. The levofloxacin concentrations in the gastric mucosa of the Hp eradication failure and successful groups were 4.869 ± 1.713 and 7.164 ± 2.097 μg/g, respectively, with statistically significant differences between the two groups. The Hp eradication rate of the seven-day group of levofloxacin-based triple therapy was similar to that of the ten-day group.
Conclusions: The levofloxacin concentration in the gastric mucosa of the successful Hp eradication group was higher than that of the eradication failure group.