Response to “Levofloxacin-containing versus Clarithromycin-containing Therapy for Helicobacter pylori Eradication: A Prospective Randomized Controlled Clinical Trial”

Sir,

I read with a great interest the article titled, “Levofloxacin-containing versus clarithromycin-containing therapy for Helicobacter pylori eradication: A prospective randomized controlled clinical trial”[1] authored by Sebghatollahi et al. I would like to compliment the authors for conducting a study on a widely prevalent disease with a very good design.

The results of this study provide many insights about the management of H. pylori infection in the current scenario.

In the inclusion criteria, the authors have mentioned that patients with peptic ulcer disease were included; however, it seems many patients in the study did not have gastric/duodenal ulcer. It looks like patients with H. pylori infection with peptic ulcer disease or dyspepsia both were included.

Although there was no significant difference in two groups, many findings including numerically higher eradication rate, lower incidence of self-reported adverse events, and severe intolerance are in favor of the pantoprazole, bismuth subcitrate, amoxicillin and clarithromycin (PBAC), i.e., clarithromycin-containing group. In the absence of significant difference between the two groups, comparative data on compliance of two regimens may be useful for a clinical decision of selecting one regimen over the other. If medicines are not provided in the kit, there are chances of lesser compliance in the pantoprazole, bismuth subcitrate, amoxicillin 1 g, tinidazole for 7 days, followed by levofloxacin for next 7 days (PBATL) group, because patients need to change from tinidazole to levofloxacin after a week unlike in the PBAC group where therapy was same for 14 days.

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