Comparison between the two drug regimens of PPI+Amoxicillin+ Rifampicin and PPI+Amoxicillin+ Levofloxacin for the treatment of H. pylori infections resistant to the first line drug regimen among patients referred to Ilam clinics

AIM: This study compares the effects of two drug regimens for Helicobacter pylori (H. pylori) infection resistant to the first line drug regimen among patients referred to Ilam clinics, Iran. BACKGROUND: Single drug regimen is not effective for H. pylori infection and therefore, application of triple or quadruple drug regimens are currently applied. METHODS: This study was performed by a before-after comparative method and patients were randomly selected among those consecutively referred to Ilam gastrointestinal clinics. Patients with failure in the first line treatment, were randomly divided into two equal groups and each group was treated by one of the PPI+Amoxicillin+Rifampicin or PPI+Amoxicillin+Levofloxacin drug regimens for 14 days. Six weeks after treatment, patients were tested for H. pylori stool antigen and the results were compared between two groups. RESULTS: In this study, 100 patients including 49 (49%) men and 51 (51%) women were examined. There was no statistical difference between the two groups for gender, age and living location at the start of study (p = 0.068). The mean age of the patients was 44.55 ±15.1 years old ranging from 17 to 85 years. Response to treatment among the levofloxacin group, was 90% and in rifampicin group 72% with a significant difference (p<0.04). CONCLUSION: The response rate of H. pylori infection to the Levofloxacin based regimen was 90%; however, the application of rifampicin in combination with other drugs against H. pylori infection (72% response rate), should be limited to reduce the possibility of drug resistance in case of tuberculosis infection.