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ObjectivesThis study aimed to investigate 7 and 10 d courses of levofloxacin-based triple therapy and the effect of levofloxacin concentration in gastric mucosa on Helicobacter pylori (Hp) eradication.MethodsLevofloxacin (500 mg qd), esomeprazole (20 mg bid) and amoxicillin (1000 mg bid) were applied to treat 240 Hp-positive chronic gastritis patients. Patients were randomly divided into 7 and 10 d groups (n = 120 in each group). 14C breath tests of the patients were reviewed 4 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 7 d group to determine levofloxacin concentration by using endoscopic biopsy.ResultsA total of 224 patients completed follow-up. Intention-to-treat and per-protocol analyses showed that the Hp eradication rates of the 10 d group were 81.7% and 88.3%, while those of the 7 d group were 78.3% and 83.2%. No 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 7 d group of levofloxacin-based triple therapy was similar to that of the 10 d group.ConclusionThe levofloxacin concentration in the gastric mucosa of the successful Hp eradication group was higher than that of the eradication failure group.

Levofloxacin-based Triple Therapy for Eradicating Helicobacter Pylori and Effect of its Drug Concentration