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document
A randomized study comparing levofloxacin , omeprazole , nitazoxanide , and doxycycline versus triple therapy for the eradication of Helicobacter pylori . OBJECTIVES Resistance to standard Helicobacter pylori ( HP ) treatment regimens has led to unsatisfactory cure rates in HP-infected patients . This study was designed to evaluate a novel four-drug regimen ( three antibiotics and a proton pump inhibitor ( PPI ) ) for eradication of HP infection in treatment-naive patients . METHODS Patients with a diagnosis of HP gastritis or peptic ulcer disease confirmed using endoscopy and stool antigen testing were eligible for inclusion in this study . All patients underwent a washout period of 6 weeks from any prior antibiotic or PPI usage . Patients were then randomized to either levofloxacin , omeprazole , nitazoxanide , and doxycycline ( LOAD ) therapy for 7 days ( LOAD-7 ) or 10 days ( LOAD-10 ) , including levofloxacin 250 mg with breakfast , omeprazole 40 mg before breakfast , nitazoxanide ( Alina ) 500 mg twice daily with meals and doxycycline 100 mg at dinner , or lansoprozole , amoxicillin , and clarithromycin ( LAC ) therapy for 10 days , which included lansoprozole 30 mg , amoxicillin 1 g with breakfast and dinner , and clarithromycin 500 mg with breakfast and dinner . HP eradication was confirmed by stool antigen testing at least 4 weeks after cessation of therapy . RESULTS Intention-to-treat analysis revealed significant differences ( P < 0.05 ) in the respective eradication rates of the LOAD therapies ( 88.9 % ( 80/90 ) LOAD-10 , 90 % ( 81/90 ) LOAD-7 , 89.4 % ( 161/180 ) for combined LOAD ) compared with those receiving LAC , 73.3 % ( 66/90 ) . There were no differences in adverse effects between the groups . CONCLUSIONS This open-label , prospective trial demonstrates that LOAD is a highly active regimen for the treatment of HP in treatment-naive patients . A large randomized controlled trial is warranted to further evaluate the efficacy of this regimen .
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Intervention_Pharmacological
levofloxacin , omeprazole , nitazoxanide
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Intervention_Pharmacological
doxycycline
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Intervention_Pharmacological
triple therapy
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Intervention_Pharmacological
four-drug regimen
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Intervention_Pharmacological
levofloxacin , omeprazole , nitazoxanide , and doxycycline ( LOAD )
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Intervention_Pharmacological
levofloxacin 250 mg with breakfast , omeprazole 40 mg before breakfast , nitazoxanide ( Alina ) 500 mg twice daily
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Intervention_Pharmacological
doxycycline 100 mg
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Intervention_Pharmacological
lansoprozole , amoxicillin , and clarithromycin ( LAC ) therapy
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Intervention_Pharmacological
lansoprozole 30 mg , amoxicillin 1 g with breakfast and dinner , and clarithromycin 500 mg
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Intervention_Pharmacological
LOAD
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Outcome_Physical
Helicobacter pylori
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Outcome_Physical
stool antigen testing
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Outcome_Other
Intention-to-treat analysis
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Outcome_Physical
eradication rates
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Outcome_Adverse-effects
adverse effects
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Participant_Condition
HP-infected patients .