Efficacy of first-line levofloxacin-based therapy for Helicobacter pylori eradication. Results from a single tertiary center cohort in Argentina.

[BACKGROUND AND OBJECTIVE] Helicobacter pylori (H. pylori) colonizes the gastric mucosa in approximately half of the global population and is a well-established risk factor for peptic ulcer disease and gastric adenocarcinoma. Data on the effectiveness of levofloxacin-based eradication regimens in Argentina remain scarce. The objective of the study was to evaluate the eradication efficacy of a 14-day levofloxacin-containing triple therapy regimen in treatment-naïve patients with H. pylori infection.

[PATIENTS AND METHODS] This single-center retrospective study included treatment-naïve adult patients with histologically confirmed H. pylori infection between 09/2020 and 07/2023. Patients received a 14-day regimen consisting of amoxicillin 1g twice daily, levofloxacin 500mg once daily, and pantoprazole 40mg twice daily. Eradication was assessed by C-urea breath test performed at least 4 weeks following treatment completion.

[RESULTS] The study included 277 patients (median age 57 years; 60.6% female). The eradication rate was 76.2% evaluated through modified intention to treat analysis. Eradication rates did not differ by age, sex, body mass index, or other baseline clinical characteristics. Treatment-related adverse events occurred in 11 (4%) patients and 6 (2.2%) patients did not complete the prescribed treatment regimen due to adverse events.

[CONCLUSION] The 14-day levofloxacin-based triple therapy regimen achieved a suboptimal H. pylori eradication rate, falling below the internationally recommended threshold above 90%. These results indicate this regimen should not be considered as first-line therapy in our region, and alternative regimens with higher efficacy should be prioritized.