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Levofloxacin-Amoxicillin/Clavulanate-Rabeprazole versus a Standard Seven-Day Triple Therapy for Eradication of Helicobacter pylori Infection
Open accessAbstract
The resistance rates of Helicobacter pylori to amoxicillin and metronidazole therapy are higher in eastern Taiwan as compared to national and worldwide rates. The high resistance rate in this territory justified a search for a better eradication regimen. We conducted an open-labeled, prospective, randomized, and controlled study in a tertiary referral hospital in eastern Taiwan. Between December 2007 and December 2009, a total of 153 Helicobacter pylori-positive, therapy-naïve patients with a positive rapid urease test were recruited for random assignment to two seven-day treatment groups: levofloxacin (500 mg), amoxicillin/clavulanate (875 mg/125 mg), and rabeprazole (20 mg) twice per day (LAcR) or clarithyromicin (500 mg), amoxicillin (1000 mg), and rabeprazole (20 mg) twice per day (CAR). Helicobacter pylori eradication was assessed using the (13)C-urea breath test or rapid urease test performed at least 4 weeks after the end of treatment. After exclusion, 146 patients were enrolled and allocated in the study. The Helicobacter pylori eradication rates analyzed by both intention to treat (78.1% versus 57.5%, P = 0.008) and perprotocol (80.9% versus 61.8%, P = 0.014) were significantly higher for the LAcR group. In conclusion, the seven-day LAcR regimen provided improved Helicobacter pylori eradication efficacy when compared with the standard CAR triple therapy in eastern Taiwan.
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“In a comparative study from Eastern Taiwan, the LAcR regimen, comprising levofloxacin, amoxicillin/clavulanate, and rabeprazole, achieved significantly higher eradication and symptom resolution rates than standard clarithromycin-based triple therapy (78.1% vs. 57.5%, p<0.05), underscoring the therapeutic relevance of co-amoxiclav-containing regimens in resistance-tailored treatment strategies [23]”
From Clinical Outcomes and Real-World Effectiveness of Amoxicillin-Clavulanic Acid Across Indian Healthcare Settings: A Retrospective Multicenter Study (2026) · cites this paper as [23]
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Cited by
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Raju, A., Kakar, A., Bhagat, D. K., Behera, S. K., Pathak, R., & Pal, S. (2026) · Cureus · doi:10.7759/cureus.104282
“…and rabeprazole, achieved significantly higher eradication and symptom resolution rates than standard clarithromycin-based triple therapy (78.1% vs. 57.5%, p 0.05), underscoring the therapeutic relevance of co-amoxiclav-containing regimens in resistance-tailored treatment strategies [23].”
Influential
Metadata
- Authors
- Chen, M.-C., Lei, W.-Y., Lin, J.-S., Yi, C.-H., Wu, D.-C., & Hu, C.-T.
- Affiliations
- Luodong Poh-Ai Hospital (TW)
- Tzu Chi Foundation (TW)
- Tzu Chi University (TW)
- Kaohsiung Medical University (TW)
- Corresponding author
- Hu, Chi-Tan
- Venue
- BioMed Research International
- Publisher
- Hindawi Limited
- Published
- 2014
- Volume
- 2014
- Pages
- 1-7
- ISSN
- 1110-7243 (ISSN-L)
- 2314-6133
- 2314-6141
- PMC
- PMC4066685
- OpenAlex
- W1975241840
- Cited by
- 21
- References
- 36
- Citations by year
- 2026: 1 · 2024: 2 · 2023: 1 · 2022: 1 · 2020: 1 · 2018: 2 · 2017: 3 · 2016: 3 · 2015: 6
- FWCI
- 3.96
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Locations
- BioMed Research International (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Topics
- Health Sciences › Medicine › Gastroenterology › Helicobacter pylori-related gastroenterology studies
- Health Sciences › Medicine › Hepatology › Hepatitis C virus research
- Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
- Keywords
- Helicobacter pylori, triple therapy, levofloxacin, amoxicillin-clavulanic acid, rabeprazole, clarithromycin, amoxicillin, eradication efficacy, antibiotic resistance, 13C-urea breath test, rapid urease test, eastern Taiwan
- MeSH terms
- Amoxicillin, Drug Combinations, Female, Humans, Male, Helicobacter pylori, Helicobacter Infections, Clavulanic Acid, Drug Resistance, Bacterial, Levofloxacin, Rabeprazole
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