Efficacy of Clarithromycin vs. Levofoxacin-Based Regimens in Treating H.pylori in Treatment-naïve Patients After Antibiotic Misuse Due to the COVID-19 Pandemic

In a recent study published in BMC infectionresearchers investigated the eradication rate Helicobacter pylori A levofloxacin- and clarithromycin-based regimen was utilized in previously treated patients with coronavirus disease 2019 (COVID-19).

Background

Helicobacter pylori (Helicobacter pylori) affects half of the world’s population.chronic gastritis, some stomach cancers, and peptic ulcerIt has also been associated with extra-intestinal diseases such as treatment-resistant iron deficiency anemia, vitamin B12 deficiency, and immune thrombocytopenic purpura. pylori eradication rates may be affected by antibiotic use during the COVID-19 pandemic.

About research

In this study, researchers assessed efficacy of Clarithromycin compared with levofloxacin-based therapy Helicobacter pylori Treatment of antibiotic-naïve individuals after the COVID-19 pandemic.

This study included a randomized controlled trial conducted from March 21, 2021 to September 30, 2021, in which patients were recruited from the outpatient center of Alexandria University Hospital and were recruited from physicians working in outpatient and inpatient facilities. Was introduced.Eligible participants included newly diagnosed patients aged 18–65 years Helicobacter pylori Infected and previously treated for COVID-19.Diagnosis was made positive Helicobacter pylori stool antigenrapid urease test, urea breath test, or Helicobacter pylori Detection during histological analysis of gastric biopsies.

This test includes endoscopy for evaluation of peptic ulcer, history of peptic ulcer, history or presence of stomach cancer, dyspepsia, chronic aspirin or pain reliever use, and upper gastrointestinal (GI) symptoms. It was performed on individuals with a history of testing. The major chief complaint of each patient was recorded. The first group was treated with amoxicillin, clarithromycin, and esomeprazole, and the second group received esomeprazole, levofloxacin, and amoxicillin.

All patients were provided with comprehensive historical data, including demographic information and social history of alcohol or tobacco intake, as well as comprehensive clinical and laboratory examinations. Patient compliance was estimated by counting remaining tablets at predetermined intervals. All patients were required to complete a side effect questionnaire. The severity of each symptom was rated from absent (0) to severe (3). After 6-8 weeks of treatment, the team assessed H. pylori eradication for a minimum of 4 weeks after antibiotic discontinuation and for a minimum of 2 weeks without PPIs.

result

A total of 270 participants, including 135 in each arm, participated in this study. Approximately 19 patients in the clarithromycin cohort and her 18 patients in the levofloxacin cohort discontinued treatment within her 2–4 days due to adverse outcomes or were available for follow-up prior to evaluation of H. lost.. Helicobacter pylori eradication. Subsequently, his 116 participants in the clarithromycin cohort and his 117 participants in the levofloxacin group were evaluated.

The average age of the participants was 41.9±13.0 years, 58.8% were male, 63.4% were married, 88.0% lived in metropolitan areas, and 60.1% had no history of chronic diseases. The remaining patients showed compliance of 80% or more. The team noted no statistically significant differences between levofloxacin-based and clarithromycin-based regimens with respect to baseline characteristics, major chief complaints, and diagnostic tests employed. Nearly 25.5% of the patients surveyed were smokers, but none reported drinking alcohol.

Overall Helicobacter pylori The eradication response rate was 69.53%. Intent-to-treat (ITT) and per-protocol (PP) analyzes showed that patients treated with levofloxacin-based regimens had treatment responses of 64.44% and 74.36%, respectively. In contrast, patients treated with clarithromycin-based regimens had treatment responses of 55.6% and 64.66%, respectively. However, these differences did not have statistical significance. Additionally, the team noted no statistically significant difference between adverse effects reported by the two treatment groups.

Conclusion

Study results showed that among participants with a previous history of COVID-19 treatment, both levofloxacin- and clarithromycin-based regimens resulted in less than acceptable eradication rates.

The researchers believe that this finding should give cause for concern regarding the increase in antibiotic resistance in these individuals and populations. was Helicobacter pylori Treatment costs are high and the risk of H. pylori-related illness increases.

explain the precise mechanisms of antibiotic resistance to Helicobacter pylori Additional studies are needed in such patients. In light of the increasing prevalence of antibiotic resistance, this study will help policy makers determine the most cost-effective approaches. Helicobacter pylori treatment.